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Pediatric sedation AND ketamine

Rachel Myers, Jeanette Lozenski, Matthew Wyatt, Maria Peña, Kayla Northrop, Dhaval Bhavsar, Anthony Kovac
Pain and sedation management for patients undergoing burn dressing change can be challenging. Variations appear to exist in the selection of medications before and during burn dressing change. To determine if institutional variations exist in pain and sedation management for burn dressing change, an online survey was sent to ABA Burn Center nurses and physicians. Three hundred seventy-eight anonymous responses were received from nurses (72%), nurse practitioners (10%), and physicians (18%). Burn centers had adult (22%), pediatric (12%), or pediatric and adult (66%) patients...
August 18, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Maha A AlSarheed
OBJECTIVES: To identify the intranasal (IN) sedatives used to achieve conscious sedation during dental procedures amongst children. METHODS: A literature review was conducted by identifying relevant studies through searches on Medline. Search included IN of midazolam, ketamine, sufentanil, dexmedetomidine, clonidine, haloperidol, and loranzepam. Studies included were conducted amongst individuals below 18 years, published in English, and were not restricted by year...
September 2016: Saudi Medical Journal
Jocelyn R Grunwell, Curtis Travers, Courtney E McCracken, Patricia D Scherrer, Anne G Stormorken, Corrie E Chumpitazi, Mark G Roback, Jana A Stockwell, Pradip P Kamat
OBJECTIVE: Most studies of ketamine administered to children for procedural sedation are limited to emergency department use. The objective of this study was to describe the practice of ketamine procedural sedation outside of the operating room and identify risk factors for adverse events. DESIGN: Observational cohort review of data prospectively collected from 2007 to 2015 from the multicenter Pediatric Sedation Research Consortium. SETTING: Sedation services from academic, community, free-standing children's hospitals and pediatric wards within general hospitals...
August 8, 2016: Pediatric Critical Care Medicine
Marina Perelló, David Artés, Cristina Pascuets, Elisabeth Esteban, Ana Maria Ey
STUDY DESIGN: Randomized, double-blind, placebo-controlled study, with a six-month follow-up period. OBJECTIVES: To test the hypothesis that a 72-hour dose of subanesthetic ketamine in this surgical procedure reduces postoperative morphine use; To assess if there are fewer adverse effects, if postoperative recovery is faster, if there is less peri-incisional hyperalgesia or if there is lower incidence of persistent postsurgical pain. SUMMARY OF BACKGROUND DATA: Tissue injury and high opioid requirements following posterior spinal fusion surgery produce central sensitization, which can in turn be associated with hyperalgesia and chronic pain...
July 7, 2016: Spine
Dilek Gunay Canpolat, Mustafa Denizhan Yildirim, Recep Aksu, Nukhet Kutuk, Alper Alkan, Kenan Cantekin
BACKGROUND AND OBJECTIVE: Dental treatments cannot bealways performed under local anesthesia inpediatric non-cooperative patients. For this purpose, differentanesthetic techniques have been applied to increase patient comport to dental treatments. METHODS: Sixty children classified as ASA I-II, between aged 3 to 9, who were scheduled to undergo tooth extraction, were enrolled for this randomized study. Group K received 1 mg/kg ketamine, Group P received 1 mg/kg propofol, and Group KP received 0...
May 2016: Pakistan Journal of Medical Sciences Quarterly
Orit Rubinstein, Shiri Barkan, Rachelle Breitbart, Sofia Berkovitch, Michal Toledano, Giora Weiser, Natali Karadi, Anat Nassi, Eran Kozer
OBJECTIVE: To assess the efficacy of oral ketamine versus oral midazolam for sedation during laceration repair at a pediatric emergency department. METHODS: Children between 1 and 10 years requiring laceration repair were randomly assigned to 2 groups, treated either with oral midazolam (0.7 mg/kg) or with oral ketamine (5 mg/kg).Main outcomes measured were level of pain during local anesthesia, as assessed by the parent on a 10-cm visual analog scale (VAS) and the number of children who required intravenous sedation...
June 2016: Medicine (Baltimore)
Giath Gazal, Wamiq Musheer Fareed, Muhammad Sohail Zafar, Khalid H Al-Samadani
For fearful and uncooperative children behavioral management techniques are used. In order to control the pain and anxiety in pedodontic patients, pharmacologic sedation, anesthesia and analgesia are commonly used. Midazolam is commonly used as an oral sedation agent in children; it has several features such as safety of use, quick onset and certain degree of amnesia that makes it a desirable sedation agent in children. This review paper discusses various aspects of oral midazolam, ketamine and their combinations in conscious sedation including, advantages of oral route of sedation, pharmacokinetics, range of oral doses, and antagonists for clinical dental treatment procedures...
July 2016: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Parul Uppal Malhotra, Seema Thakur, Parul Singhal, Deepak Chauhan, Cheranjeevi Jayam, Ritu Sood, Yagyeshwar Malhotra
BACKGROUND: Pharmacological methods have been used as an adjunct to enhance child cooperativeness and facilitate dental treatment. OBJECTIVE: Purpose of this study was to evaluate and compare the effect of sedation by intranasal dexmedetomidine and oral combination drug midazolam-ketamine in a group of children with uncooperative behavior requiring dental treatment. MATERIALS AND METHODS: This was a prospective, randomized, double-blind study that included patients 3-9 years old with American Society of Anesthesiologists-I status...
April 2016: Contemporary Clinical Dentistry
Ravi Bhat, M C B Santhosh, Venkatesh M Annigeri, Raghavendra P Rao
BACKGROUND: Goal of premedication in pediatric anesthesia are relieving pre and postoperative anxiety, good parental separation, and smooth induction of anesthesia. Anxiety can produce aggressive reactions, increased distress, increased postoperative pain and postoperative agitation. The benzodiazepine, midazolam, is the most frequently used premedication in pediatric anesthesia. Midazolam has a number of beneficial effects when used as premedication in children: Sedation, fast onset, and limited duration of action...
May 2016: Anesthesia, Essays and Researches
Vigya Goyal, Jyotsna Kubre, Krishnaprabha Radhakrishnan
CONTEXT: Postoperative pain management is becoming an integral part of anesthesia care. Various techniques of pediatric pain relief have been designed among which the most commonly practiced is caudal epidural block. Several adjuvants have been used to prolong the duration of caudal analgesia such as clonidine, neostigmine, ketamine, opioids, and ephedrine. We have designed the study using dexmedetomidine as an adjuvant to assess analgesic efficacy, duration of postoperative analgesia, hemodynamic stability, postoperative sedation, and any adverse effects in children...
May 2016: Anesthesia, Essays and Researches
Vasanthi Done, Ravichandrasekhar Kotha, Aron Arun Kumar Vasa, Suzan Sahana, Raghavendra Kumar Jadadoddi, Sushma Bezawada
INTRODUCTION: Most children are casual and moderately agreeable in the dental treatment environment, however some of them show practices that upset the professional and make the protected conveyance of worthy treatment extremely troublesome. For such cases dental practitioner utilizes behavior management techniques. At the point when behavioral administration procedures come up short, some type of pharmacologic sedation or anesthesia may be an important and vital option. Dental sedation is a strategy in which the utilization of a medication or drugs produce(s) a condition of depression of the central sensory system empowering treatment to be completed during which verbal contact with the patient is kept up all through the time of sedation...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
M Simsek, M O Bulut, D Ozel, I K Yucel, Z Aykac
OBJECTIVE: Purpose of this study is to compare the effects of various anaesthetic combinations on hemodynamics, sedation level, recovery period and complications in the patients which undergo pediatric cardiac catheterization. PATIENTS AND METHODS: Four groups of anaesthetic combinations was created. The groups are classified as propofol-ketamine (group 1), propofol-dexmedetomidine (group 2), dexmedetomidine-ketamine (group 3), midazolam-ketamine (group 4) (for each group n=20)...
April 2016: European Review for Medical and Pharmacological Sciences
Alessandra Moretto, Vittorio Scaravilli, Valentina Ciceri, Mariagrazia Bosatra, Federica Giannatelli, Bianca Ateniese, Milena Mariani, Anna Cereda, Simone Sosio, Alberto Zanella, Antonio Pesenti, Angelo Selicorni
Cornelia De Lange syndrome (CdLS) is a rare congenital disease characterized by typical facial dysmorphism, developmental disability, and limb deficiency defects. Various congenital malformations and medical complications have been described with gastroesophageal reflux as the major one. CdLS patients often require multiple high-risk anesthetic procedures. At San Gerardo Hospital (Monza, Italy) the management of CdLS patients is routinely organized through a standard protocol and a dedicated pediatric anesthesia team has been implemented...
June 2016: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
Sheikh Sohail Ahmed, Shawn R Hicks, James E Slaven, Mara E Nitu
OBJECTIVE: Sedation may be needed for safe, effective completion of pediatric dental procedures. Procedural sedation is performed in a children's hospital based dental office. The three sedation approaches: a propofol-only (P-O) approach (2-3 mg/kg titrated to the needed level of sedation), an approach that includes either i.v. ketamine (K+P) (0.25 or 0.5 mg/kg) or i.v. fentanyl (F+P) (0.5-1 mcg/kg) prior to propofol administration. We sought to determine safety and efficacy of various propofol based sedation protocols...
2016: Journal of Clinical Pediatric Dentistry
Mohamed Mahmoud, Keira P Mason
PURPOSE OF REVIEW: Over the past decade, the field of pediatric sedation has benefited from contributions which include the introduction and update of policies, procedures, and guidelines regarding training, physiologic monitoring and delivery, the approval of new sedatives, the multispecialty collaborations intended to advance the field and the development of sedatives, and delivery systems. This review will explore new drug innovations as well as evolved formulations of already approved agents, unique sedative delivery systems, the clinical application of pharmacogenetics and will conclude with a reflection on the current and future trends and focus of pediatric sedation research...
March 2016: Current Opinion in Anaesthesiology
Humaira Jurair, Amyna Bhimani, Anwar-Ul-Haque
BACKGROUND AND OBJECTIVE: Procedural sedation and analgesia (PSA) is pharmacologically induced state which allows patients to tolerate painful procedures while maintaining protective reflexes. It is the standard of care but there is limited data from Pakistan. Our objective was to assess the safety of the procedural sedation and analgesia in pediatric population at a tertiary care setting. METHODS: A retrospective notes and record review was conducted at the Aga Khan University Hospital, Karachi over 4 years from April 2010 to August 2014...
November 2015: Pakistan Journal of Medical Sciences Quarterly
Lisa Hartling, Andrea Milne, Michelle Foisy, Eddy S Lang, Douglas Sinclair, Terry P Klassen, Lisa Evered
BACKGROUND: Sedation is increasingly used to facilitate procedures on children in emergency departments (EDs). This overview of systematic reviews (SRs) examines the safety and efficacy of sedative agents commonly used for procedural sedation in children in the ED or similar settings. METHODS: We followed standard SR methods: comprehensive search; dual study selection, quality assessment, data extraction. We included SRs of children (1 month to 18 years) where the indication for sedation was procedure-related and performed in the ED...
May 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
C Dong, C R Rovnaghi, K J S Anand
BACKGROUND: Developmental neurotoxicity of ketamine, an N-methyl-D-aspartate receptor antagonist, must be considered due to its widespread uses for sedation/analgesia/anesthesia in pediatric and obstetric settings. Dose-dependent effects of ketamine on cellular proliferation in the neurogenic regions of rat fetal cortex [ventricular zone (VZ) and subventricular zone (SVZ)] were investigated in this in vivo study. METHODS: Timed-pregnant Sprague-Dawley rats at embryonic day 17 (E17) were given with different doses of ketamine intraperitoneally (0, 1, 2, 10, 20, 40, and 100 mg/kg)...
May 2016: Acta Anaesthesiologica Scandinavica
Amber Thomas, Jamie L Miller, Kevin Couloures, Peter N Johnson
OBJECTIVES: The purpose of this study was to describe the method of delivery, dosage regimens, and outcomes of sedatives administered by extravascular route for imaging procedures in children. METHODS: Medline, Embase, International Pharmaceutical Abstracts, and Cochrane Database of Systematic Reviews were searched using keywords "child", "midazolam", "ketamine", dexmedetomidine", "fentanyl", "nitrous oxide", and "imaging." Articles evaluating the use of extravascular sedation in children for imaging procedures published in English between 1946 and March 2015 were included...
November 2015: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Noa Rosenfeld-Yehoshua, Baruch Klin, Matitiahu Berkovitch, Ibrahim Abu-Kishk
OBJECTIVES: In Israel, the recommendation for the use of propofol is age limited. Furthermore, procedural sedations involving propofol must be performed only by anesthesiologists. Propofol is frequently used in the PICUs in Israel. DESIGN: Questionnaire survey. SETTING: PICUs in Israel. SUBJECTS: None. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Physicians from 13 PICUs (86...
March 2016: Pediatric Critical Care Medicine
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