Pediatric sedation with analgesia

Pediatric sedation with analgesia

Bauman L; Kish I; Baumann RC; Politis GD

American Journal of Emergency Medicine

1999

Child; Intensive Care Units; Analgesics; Drug Therapy; Time Factors; Clinical Protocols; Anesthetics; Pediatric; Preschool; infant; Comparative Study; retrospective studies; Human; Opioid/therapeutic use; Adolescence; Fentanyl/therapeutic use; Combination; Propofol/therapeutic use; Analgesia/adverse effects/methods; Conscious Sedation/adverse effects/methods; Intravenous/therapeutic use

Sedation with analgesia is frequently required to perform painful or invasive procedures in children. The best medication combination for pediatric sedation with analgesia is yet to be identified. Sixty-four of 243 total sedation with analgesia procedures from January 1994 through August 1995 were randomly chosen for descriptive retrospective review and analysis. Four minor complications from the procedures were identified, and recovery was complete in all cases. One medication combination (fentanyl 1 microg/kg with propofol 1.5 to 2 mg/kg, followed by an infusion of 150 microg/kg/min) provided the shortest mean time to dismissal (17.8 minutes v 38 minutes) when compared with other combinations used. No episodes of respiratory depression, hypotension, or nausea and vomiting occurred in the fentanyl/propofol group. These results show that fentanyl/propofol was superior to other medications used during this study period for pediatric sedation with analgesia. Prospective comparison of this medication combination with other short-acting agents in patients undergoing both elective and emergency procedures is necessary.

1999

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