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Titolo:
COMPARISON OF FENTANYL MIDAZOLAM WITH KETAMINE/MIDAZOLAM FOR PEDIATRIC ORTHOPEDIC EMERGENCIES/
Autore:
KENNEDY RM; PORTER FL; MILLER JP; JAFFE DM;
Indirizzi:
WASHINGTON UNIV,ST LOUIS CHILDRENS HOSP,SCH MED,DEPT PEDIAT,DIV EMERGENCY MED,1 CHILDRENS PL ST LOUIS MO 63110 WASHINGTON UNIV,ST LOUIS CHILDRENS HOSP,SCH MED,DIV NEWBORN MED ST LOUIS MO 63110 WASHINGTON UNIV,ST LOUIS CHILDRENS HOSP,SCH MED,DIV BIOSTAT ST LOUIS MO 63110
Titolo Testata:
Pediatrics (Evanston)
fascicolo: 4, volume: 102, anno: 1998,
parte:, 1
pagine: 956 - 963
SICI:
0031-4005(1998)102:4<956:COFMWK>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
FENTANYL INTRAVENOUS SEDATION; CONSCIOUS SEDATION; KETAMINE SEDATION; PAIN CONTROL; INTRAMUSCULAR KETAMINE; RESPIRATORY ARREST; CHILDREN; MIDAZOLAM; ANESTHESIA; MEPERIDINE;
Keywords:
KETAMINE; FENTANYL; MIDAZOLAM; PEDIATRIC PROCEDURE SEDATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
54
Recensione:
Indirizzi per estratti:
Citazione:
R.M. Kennedy et al., "COMPARISON OF FENTANYL MIDAZOLAM WITH KETAMINE/MIDAZOLAM FOR PEDIATRIC ORTHOPEDIC EMERGENCIES/", Pediatrics (Evanston), 102(4), 1998, pp. 956-963

Abstract

Objective. Emergency management of pediatric fractures and dislocations requires effective analgesia, yet children's pain is often undertreated. We compared the safety and efficacy of fentanyl- versus ketamine- based protocols. Methodology. Patients 5 to 15 years of age needing emergency fracture or joint reduction (FR) were randomized to receive intravenous midazolam plus either fentanyl (F/M) or ketamine (K/M). Measures of efficacy were observational distress scores and self- and parental-report. Measures of safety were frequency of abnormalities in and need for support of cardiopulmonary function and other adverse effects. Results. During FR, K/M subjects (n = 130) had lower distress scores and parental ratings of pain and anxiety than did FIM subjects (n = 130). Although both regimens equally facilitated reductions, deep sedation, and procedural amnesia, orthopedists favored K/M. Recovery was14 minutes longer for K/M. Fewer K/M subjects had hypoxia (6% vs 25%), needed breathing cues (1% vs 12%), or required oxygen (10% vs 20%) than did FIM subjects. Two K/M:subjects required assisted ventilation briefly. More K/M subjects vomited. Adverse emergence reactions were rare but equivalent between regimens. Conclusions. During emergency pediatric orthopedic procedures, K/M is more effective than F/M for pain and anxiety relief. Respiratory complications occurred less frequently with K/M, but respiratory support may be needed with either regimen. Both regimens facilitate reduction, produce amnesia, and rarely cause emergence delirium. Vomiting is more frequent and recovery more prolonged with K/M.

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Documento generato il 05/04/20 alle ore 19:16:42