{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:21:10Z","timestamp":1789057270797,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":214,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although pediatric intravenous anesthesia is widely employed outside operating rooms, it poses risks for serious complications such as airway obstruction and apnea. In Japan, the actual numbers and trends of medical accidents associated with pediatric intravenous anesthesia remain unclear, and the safety of procedural intravenous anesthesia in children has not been sufficiently investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We extracted accident reports on pediatric intravenous anesthesia for medical procedures from a nationwide, anonymized Japanese accident registry database over 13\u2009years. The reports were analyzed to describe the clinical characteristics of the reported severe adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 79 accident reports related to intravenous anesthesia were registered, accounting for 0.017% of the total number of intravenous anesthesia procedures. Among these, 70 (88.6%) accident cases occurred in children aged 0\u20139\u2009years and 9 (11.8%) in patients older than 10\u2009years. Four cases resulted in death and eight in cardiopulmonary arrest, all involving serious underlying medical conditions and occurring during prolonged and highly invasive procedures. When categorized by age, six cases (75.0%) involved children aged 0\u20139\u2009years and 2 (25.0%) involved patients older than 10\u2009years. The most common underlying disease categories were cardiac disease (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097) and the most frequent procedures were cardiac catheterization (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095). The number of physicians exclusively assigned to anesthesia induction and monitoring using capnometers was not reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This nationwide registry analysis characterizes severe pediatric intravenous anesthesia\u2013related adverse events in Japan and highlights the importance of risk stratification and specialist involvement in high\u2010risk cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70508","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:25:33Z","timestamp":1785752733000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Is Procedural Intravenous Anesthesia Safe for Children? An Analysis of Nationwide Accident Registries in Japan"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8503-5759","authenticated-orcid":false,"given":"Megumi","family":"Matsumoto","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9442-3666","authenticated-orcid":false,"given":"Eisuke","family":"Inage","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Toriumi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8788-4042","authenticated-orcid":false,"given":"Akifumi","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Institute of Science Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6657-7342","authenticated-orcid":false,"given":"Yosuke","family":"Nakabayashi","sequence":"additional","affiliation":[{"name":"Advanced Medical Emergency Department &amp; Critical Care Center Japanese Red Cross Maebashi Hospital  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5599-0481","authenticated-orcid":false,"given":"Susumu","family":"Yokoya","sequence":"additional","affiliation":[{"name":"Thyroid and Endocrine Center, Fukushima Global Medical Science Center Fukushima Medical University  Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8677-8195","authenticated-orcid":false,"given":"Itaru","family":"Iwama","sequence":"additional","affiliation":[{"name":"Devision of Gastroenterology and Hepatology Saitama Children's Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichi","family":"Oyama","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Saiseikai Kawaguchi General Hospital  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3091-114X","authenticated-orcid":false,"given":"Nobuaki","family":"Michihata","sequence":"additional","affiliation":[{"name":"Cancer Prevention Center, Chiba Cancer Center Research Institute  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4708-8049","authenticated-orcid":false,"given":"Takahiro","family":"Kudo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8109-084X","authenticated-orcid":false,"given":"Yoshikazu","family":"Ohtsuka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2532-8910","authenticated-orcid":false,"given":"Hiromichi","family":"Shoji","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12553"},{"key":"e_1_2_11_3_1","first-page":"595","article-title":"The Current Status of Litigation Related to Sedation and the Application of the Guidelines","volume":"30","author":"Hiyama T.","year":"2015","journal-title":"Clinics in Gastroenterology"},{"key":"e_1_2_11_4_1","first-page":"1920","article-title":"Current Status of Sedation During MRI Examination at Pediatric Specialty Training","volume":"121","author":"Yamanaka 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https:\/\/www.med\u2010safe.jp\/mpsearch\/SearchReport.action."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.14331"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-3559"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14396"},{"key":"e_1_2_11_13_1","first-page":"771","article-title":"Joint Recommendations on Sedation During MRI Examinations","volume":"124","author":"Japanese Society of Pediatric Anesthesiology","year":"2020","journal-title":"Journal of Japan Pediatric Society"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.15532"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.9794\/jspccs.30.580"}],"container-title":["Pediatrics 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