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Titolo:
THE VALUE OF END-TIDAL CO2 MONITORING WHEN COMPARING 3 METHODS OF CONSCIOUS SEDATION FOR CHILDREN UNDERGOING PAINFUL PROCEDURES IN THE EMERGENCY DEPARTMENT
Autore:
HART LS; BERNS SD; HOUCK CS; BOENNING DA;
Indirizzi:
UNIV MARYLAND MED SYST,22 S GREENE ST,ROOM N1W71 BALTIMORE MD 21201
Titolo Testata:
Pediatric emergency care
fascicolo: 3, volume: 13, anno: 1997,
pagine: 189 - 193
SICI:
0749-5161(1997)13:3<189:TVOECM>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRAMUSCULAR MEPERIDINE; PEDIATRIC EMERGENCY; FENTANYL; CHLORPROMAZINE; PROMETHAZINE; DIAZEPAM;
Keywords:
END-TIDAL CO2 MONITORING; PAIN; SEDATION FOR PAIN; FENTANYL; MIDAZOLAM; MEPERIDINE; PROMETHAZINE; CHLORPROMAZINE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
18
Recensione:
Indirizzi per estratti:
Citazione:
L.S. Hart et al., "THE VALUE OF END-TIDAL CO2 MONITORING WHEN COMPARING 3 METHODS OF CONSCIOUS SEDATION FOR CHILDREN UNDERGOING PAINFUL PROCEDURES IN THE EMERGENCY DEPARTMENT", Pediatric emergency care, 13(3), 1997, pp. 189-193

Abstract

Background: Many studies have evaluated conscious sedation regimens commonly used in pediatric patients, Recent advances in capnography equipment now enable physicians to assess respiratory parameters, specifically end-tidal CO2 (et-CO2) more accurately in spontaneously breathing sedated children than was possible in the earlier studies, This study was designed to: 1) compare the safety and efficacy of intravenous fentanyl, intravenous fentanyl combined with midazolam, and intramuscular meperidine-promethazine-chlorpromazine (MPC) compound when used forpainful emergency department (ED) procedures; and 2) to determine whether the addition of et-CO2 monitoring enabled earlier identification of respiratory depression in this population. Methods: Forty-two children requiring analgesia and sedation for painful ED procedures were randomly assigned to receive either fentanyl, fentanyl-midazolam, or MPCcompound, Vital signs, oxygen saturation, and et-CO2 were monitored continuously, Pain, anxiety, and sedation scores were recorded every five minutes. Results: Respiratory depression (O-2 saturation less than or equal to 90% for over one minute or any et-CO2 greater than or equal to 50) occurred in 20% of fentanyl, 23% of fentanyl-midazolam, and 11% of MPC patients (P = NS), Of those patients manifesting respiratorydepression, 6/8 were detected by increased et-CO2 only, MPC patients required significantly longer periods of time to meet discharge criteria than fentanyl and fentanyl-midazolam patients (P < 0.05). No differences were noted in peak pain, anxiety, or sedation scores, Conclusions: Fentanyl, fentanyl-midazolam, and MPC produced a high incidence of subclinical respiratory depression, End-tidal CO2 monitoring provided an earlier indication of respiratory depression than pulse oximetry and respiratory rate alone, MPC administration resulted in a significantly delayed discharge from the ED.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/07/20 alle ore 14:49:16