Validity and reliability of the Niño Jesús Hospital procedural sedation-analgesia scale of the under deep sedation-analgesia

• Published in: Anales de Pediatría 2021-01, Vol.94 (1), p.36-45
• Main Authors: Lozano-Díaz, David, Valdivielso Serna, Alberto, Garrido Palomo, Ramón, Arias-Arias, Ángel, Tárraga López, Pedro J, Martínez Gutiérrez, Andrés
• Format: Article
• Language: Spanish
• ISSN: 2341-2879
• DOI: 10.1016/j.anpedi.2020.04.009

The procedural sedation scale of the Niño Jesús Hospital (Madrid) (SSPNJH) has not been validated. A prospective analytical study was conducted in 2 hospitals on patients ≥ 6 months undergoing invasive procedures using sedation-analgesia with propofol or midazolam and fentanyl. All were monitored using the bispectral index (BIS). Videos were made of each procedure, which were then edited and randomised. A total of 150 videos were rated by four observers using the SSPNJH, the sedation scale of the University of Michigan (UMSS), and the Ramsay Scale (SR). These observers were blinded to the BIS, and at the time of drug administration. To assess test-retest reliability, 50 of the initial 150 randomly selected videos were re-assessed. The study included a total of 65 patients. The within-observer agreement was high (ρ = 0.793). The SSPNJH gave a good interobserver reliability when compared with the UMSS (ICC = 0.88) and the SR (ICC = 0.86), and there was none with the BIS. Internal consistency was moderate (α = 0.68). Construct validity was demonstrated by changes in scores after administering sedatives (p < 0.0001). The SSPNJH had a very low correlation with the BIS (r = -0.166), and a moderate correlation with the UMSS (r = 0.497) and the SR (r = 0.405). As regards the applicability, this scale has been used in two hospitals in five different areas by four professionals of different categories. The SSPNJH is valid, reliable and applicable for sedation monitoring in invasive procedures under deep sedation-analgesia in paediatric patients. The SSPNJH has worse properties than the UMSS and the SR.