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Pediatric sedation AND ketamine

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https://www.readbyqxmd.com/read/28928560/age-based-local-anesthetic-dosing-in-pediatric-spinal-anesthesia-evaluation-of-a-new-formula-a-pilot-study-in-indian-patients
#1
S Parthasarathy, T Senthilkumar
BACKGROUND: Spinal anesthesia is a safe alternative to general anesthesia and often the anesthetic technique of choice in many lower abdominal and lower limb surgeries in children. As the vertebral column and spinal cord grows variedly with age and not weight, we planned to administer an age-based dosing schedule of hyperbaric bupivacaine in the intra-thecal space in select infra umbilical surgeries in children. The aim was to find out the efficacy and complications associated with this dosage...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#2
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVE: We compared the tolerability and efficacy of intranasal sub-dissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared intranasal ketamine 1 mg/kg to intranasal fentanyl 1.5 μg/kg in children 4-17 years old with acute pain from suspected, isolated extremity fractures presenting to an urban level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28877328/procedural-sedation-with-ketamine-versus-propofol-for-closed-reduction-of-pediatric-both-bone-forearm-fractures
#3
Todd Morrison, Chris Carender, Brendan Kilbane, Raymond W Liu
Effective treatment of pediatric both bone forearm fractures consists of timely restoration of anatomic alignment with manipulation and immobilization, often accomplished with the aid of procedural sedation in the emergency department setting. The current lack of consensus regarding a safe and optimal regimen may result in inadequate sedation, compromised quality of reduction, or patient harm. The current study was conducted to answer the following questions for pediatric both bone forearm fractures treated with closed reduction with either ketamine or propofol procedural sedation: (1) Is there a difference in the rate of unacceptable alignment 4 weeks after reduction? (2) Is there a difference in the rates of major sedation-related complications? Medical records, data on procedural sedation, and radiographs of 74 skeletally immature patients with diaphyseal or distal metaphyseal both bone forearm fractures treated with manipulation were reviewed (ketamine sedation, 26; propofol sedation, 48)...
September 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28828486/risk-factors-for-adverse-events-in-emergency-department-procedural-sedation-for-children
#4
Maala Bhatt, David W Johnson, Jason Chan, Monica Taljaard, Nick Barrowman, Ken J Farion, Samina Ali, Suzanne Beno, Andrew Dixon, C Michelle McTimoney, Alexander Sasha Dubrovsky, Nadia Sourial, Mark G Roback
Importance: Procedural sedation for children undergoing painful procedures is standard practice in emergency departments worldwide. Previous studies of emergency department sedation are limited by their single-center design and are underpowered to identify risk factors for serious adverse events (SAEs), thereby limiting their influence on sedation practice and patient outcomes. Objective: To examine the incidence and risk factors associated with sedation-related SAEs...
August 21, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28798230/association-of-bmi-with-propofol-dosing-and-adverse-events-in-children-with-cancer-undergoing-procedural-sedation
#5
Colin M Rogerson, Kamal Abulebda, Michael J Hobson
OBJECTIVES: Obesity increases the risk of complications during pediatric procedural sedation. The risk of being underweight has not been evaluated in this arena. We therefore investigated the association of BMI with sedation dosing and adverse events in children across a range of BMIs. METHODS: A total of 1976 patients ages 2 to 21 years old with oncologic diagnoses underwent lumbar punctures and/or bone marrow aspirations. All children received a standard adjunctive dose of ketamine before sedation with propofol...
August 10, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28702841/comparison-of-ketamine-and-ketofol-for-deep-sedation-and-analgesia-in-children-undergoing-laser-procedure
#6
Marija Stevic, Nina Ristic, Ivana Budic, Nebojsa Ladjevic, Branislav Trifunovic, Ivan Rakic, Marko Majstorovic, Ivana Burazor, Dusica Simic
The aim of our study was to research and evaluate cardiovascular and respiratory stability, clinical efficacy, and safety of two different anesthetic agents in pediatric patients who underwent Pulse dye (wavelength 595 nm, pulse duration 0-40 ms, power 0-40 J) and CO2 (wavelength 10,600 nm, intensity-fraxel mod with SX index 4 to 8, power 0-30 W) laser procedure. This prospective non-blinded study included 203 pediatric patients ASA I-II, aged between 1 month and 12 years who underwent short-term procedural sedation and analgesia for the laser procedure...
July 12, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28650904/pediatric-procedural-sedation-using-the-combination-of-ketamine-and-propofol-outside-of-the-emergency-department-a-report-from-the-pediatric-sedation-research-consortium
#7
Jocelyn R Grunwell, Curtis Travers, Anne G Stormorken, Patricia D Scherrer, Corrie E Chumpitazi, Jana A Stockwell, Mark G Roback, Joseph Cravero, Pradip P Kamat
OBJECTIVES: Outcomes associated with a sedative regimen comprised ketamine + propofol for pediatric procedural sedation outside of both the pediatric emergency department and operating room are underreported. We used the Pediatric Sedation Research Consortium database to describe a multicenter experience with ketamine + propofol by pediatric sedation providers. DESIGN: Prospective observational study of children receiving IV ketamine + propofol for procedural sedation outside of the operating room and emergency department using data abstracted from the Pediatric Sedation Research Consortium during 2007-2015...
August 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28642966/procedural-sedation-and-analgesia-for-pediatric-shock-wave-lithotripsy-a-10-year-experience-of-single-institution
#8
Banu Cevik, Murat Tuncer, Kutlu Hakan Erkal, Bilal Eryildirim, Kemal Sarica
The aim of this study was to evaluate anesthesia practice for pediatric extracorporeal shock wave lithotripsy (ESWL) according to the age groups and discuss the anesthetic management of these patients. Pediatric patients treated with ESWL because of urolithiasis under anesthesia in our department between December 2007 and January 2017 were evaluated retrospectively. A total of 251 patients were divided into two groups as Group PS: preschool children (<6 years) and Group S: school children (≥6 years)...
June 22, 2017: Urolithiasis
https://www.readbyqxmd.com/read/28597354/pharmacologic-considerations-for-pediatric-sedation-and-anesthesia-outside-the-operating-room-a-review-for-anesthesia-and-non-anesthesia-providers
#9
REVIEW
Narjeet Khurmi, Perene Patel, Molly Kraus, Terrence Trentman
Understanding the pharmacologic options for pediatric sedation outside the operating room will allow practitioners to formulate an ideal anesthetic plan, allaying anxiety and achieving optimal immobilization while ensuring rapid and efficient recovery. The authors identified relevant medical literature by searching PubMed, MEDLINE, Embase, Scopus, Web of Science, and Google Scholar databases for English language publications covering a period from 1984 to 2017. Search terms included pediatric anesthesia, pediatric sedation, non-operating room sedation, sedation safety, and pharmacology...
June 8, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28433211/adverse-events-during-a-randomized-trial-of-ketamine-versus-co-administration-of-ketamine-and-propofol-for-procedural-sedation-in-a-pediatric-emergency-department
#10
Keith Weisz, Lalit Bajaj, Sara J Deakyne, Lina Brou, Alison Brent, Joseph Wathen, Genie E Roosevelt
BACKGROUND: The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication. OBJECTIVE: Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED). METHODS: This was a prospective, randomized, single-blinded, controlled trial of KM vs...
July 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28399933/intranasal-sedation-using-ketamine-and-midazolam-for-pediatric-dental-treatment-naso-study-protocol-for-a-randomized-controlled-trial
#11
Heloisa Sousa Gomes, Analya Rodrigues Miranda, Karolline Alves Viana, Aline Carvalho Batista, Paulo Sucasas Costa, Anelise Daher, Geovanna de Castro Morais Machado, Joji Sado-Filho, Liliani Aires Candido Vieira, Patrícia Corrêa-Faria, Marie Therese Hosey, Luciane Rezende Costa
BACKGROUND: Uncooperative children may need to receive dental treatment under sedation, which is indicated when nonpharmacological behavior guidance is unsuccessful. There are randomized controlled trials (RCTs) comparing different sedative protocols for dental procedures; however, the evidence for superiority of one form over another is weak. The primary aim of this study is to investigate the efficacy of intranasally administered ketamine plus midazolam for the dental treatment of children...
April 11, 2017: Trials
https://www.readbyqxmd.com/read/28366351/when-to-pick-the-nose-out-of-hospital-and-emergency-department-intranasal-administration-of-medications
#12
REVIEW
Megan A Rech, Brian Barbas, Whitney Chaney, Elizabeth Greenhalgh, Charles Turck
The intranasal route for medication administration is increasingly popular in the emergency department and out-of-hospital setting because such administration is simple and fast, and can be used for patients without intravenous access and in situations in which obtaining an intravenous line is difficult or time intensive (eg, for patients who are seizing or combative). Several small studies (mostly pediatric) have shown midazolam to be effective for procedural sedation, anxiolysis, and seizures. Intranasal fentanyl demonstrates both safety and efficacy for the management of acute pain...
August 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28217052/topical-versus-caudal-ketamine-bupivacaine-combination-for-postoperative-analgesia-in-children-undergoing-inguinal-herniotomy
#13
Hala Saad Abdel-Ghaffar, Seham Mohamed Moeen, Ahmed Mohamed Moeen
BACKGROUND: Multiple studies claim that caudal administration of ketamine causes effective postoperative analgesia. The aim of this study was to assess the clinical effectiveness of ketamine after caudal or topical administration in pediatric patients undergoing inguinal herniotomy. PATIENTS AND METHODS: This randomized, comparative, double-blind study included eighty children (aged 6 months to 6 years) received either 1 ml/kg of 0.25% bupivacaine/ketamine 0.5 mg/kg for caudal analgesia (caudal group) or 0...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28182021/procedural-moderate-sedation-with-ketamine-in-pediatric-critical-care-unit
#14
Tarek R Hazwani, Hala Al-Alem
OBJECTIVE: To evaluate the safety and efficacy of moderate sedation in the Pediatric Intensive Care Unit (PICU) settings according to moderate sedation protocol using ketamine and midazolam and to determine areas for the improvement in our clinical practice. SETTINGS AND DESIGN: A retrospective study was conducted in the PICU. MATERIALS AND METHODS: Retrospective chart review was performed for patients who had received moderate sedation between January and the end of December 2011 and who are eligible to inclusion criteria...
January 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28176512/respiratory-adverse-events-during-upper-digestive-endoscopies-in-children-under-ketamine-sedation
#15
Jose C Flores-González, Alfonso M Lechuga Sancho, Mónica Saldaña Valderas, Gema Jimenez Gomez, Maria D Cruzado Garcia, Cristina Perez Aragon, Jose A Blanca Garcia
BACKGROUND: There is no evidence of the need for oxygen supplementation during upper digestive endoscopies under Ketamine sedation in children, and the latest recommendations specifically state that it is not mandatory for the procedure. The aim of our study is to assess the incidence of respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation when performed without oxygen supplementation, in accordance with the latest recommendations. METHODS: 88 children undergoingketamine sedation for programmed upper digestive endoscopy at our Pediatric Intensive Care Unit were included...
February 7, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28147385/presentation-of-a-sedation-standard-using-the-example-of-transesophageal-echocardiographies-tee-in-pediatric-outpatients
#16
H Sauer, J Pfeifer, S Gräber, H Abdul-Khaliq
Introduction Most pediatric patients require deep sedation for a TEE examination. We analyzed the data of our sedation protocols relating to all outpatient TEEs in patients under 18 years of age for the year 2011. On the basis of the data records of a total of 40 patients, we will describe our standard and compare it with the findings of the international literature. Material and Methods In a retrospective analysis, we inspected our sedation protocols in terms of patient-related data, vital parameters, drug applications, occurring complications and necessary interventions as well as nausea and vomiting during the post-sedative monitoring phase...
January 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28121974/intranasal-analgesia-and-sedation-in-pediatric-emergency-care-a-prospective-observational-study-on-the-implementation-of-an-institutional-protocol-in-a-tertiary-children-s-hospital
#17
Marcus Nemeth, Nils Jacobsen, Carsten Bantel, Melanie Fieler, Robert Sümpelmann, Christoph Eich
OBJECTIVES: Children presenting with acute traumatic pain or in need of therapeutic or diagnostic procedures require rapid and effective analgesia and/or sedation. Intranasal administration (INA) promises to be a reliable, minimally invasive delivery route. However, INA is still underused in Germany. We hence developed a protocol for acute pain therapy (APT) and urgent analgesia and/or sedation (UAS). Our aim was to evaluate the effectiveness and safety of our protocol. METHODS: We performed a prospective observational study in a tertiary children's hospital in Germany...
January 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27939800/changes-in-blood-pressure-and-heart-rate-during-sedation-with-ketamine-in-the-pediatric-ed
#18
Adam C Patterson, Shernaz A Wadia, Douglas J Lorenz, Michelle D Stevenson
BACKGROUND: Ketamine is commonly used in the emergency department for short, painful procedures. We describe changes in blood pressure (BP) and heart rate (HR) during procedural sedation with ketamine, as these changes have not been well described in children. METHODS: We performed a secondary analysis of a prospective, observational study involving children aged 8 to 18 years who received procedural sedation with ketamine in a pediatric emergency department. Serial vital signs and sedation scores were recorded from baseline until recovery from ketamine procedural sedation...
February 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27882039/pediatric-tooth-extractions-under-sedoanalgesia
#19
Ayse Hande Arpaci, Berrin Isik
OBJECTIVE: The present study aims to evaluate intravenous ketamine and inhalation sedation in children, their unwanted side-effects and surgeon satisfaction. METHODS: In this study, data of 922 children aged between 1-18 who underwent tooth extraction under sedoanalgesia in our department between September 2015-January 2016 were gathered and anesthesia approaches, unwanted side effects and surgical satisfaction was investigated. Postoperative recovery emergence agitation or delirium was evaluated with Watcha Behavior Scale (WBS)...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27800539/comparing-two-different-doses-of-intravenous-midazolam-in-pediatric-sedation-and-analgesia
#20
Hassan Barzegari, Kambiz Masoumi, Hassan Motamed, Behzad Zohrevandi, Shima Zeynadini Meymand
INTRODUCTION: Midazolam has turned into a common drug for pediatric procedural sedation and analgesia. However, there is not much data regarding its proper dose and potential side effects in the Iranian children population. Therefore, the present study was done to compare 2 doses of IV midazolam in this regard. METHODS: The present clinical trial was performed to compare 0.1 and 0.3 mg/kg doses of IV midazolam in induction of sedation for head trauma infant patients in need of brain computed tomography (CT) scan...
November 2016: Emergency (Tehran, Iran)
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