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Titolo:
Etomidate for pediatric sedation prior to fracture reduction
Autore:
Dickinson, R; Singer, AJ; Carrion, W;
Indirizzi:
SUNY Stony Brook, Univ Med Ctr L4 515, Dept Emergency Med, Stony Brook, NY11794 USA SUNY Stony Brook Stony Brook NY USA 11794 y Med, Stony Brook, NY11794 USA SUNY Stony Brook, Dept Orthoped, Stony Brook, NY 11794 USA SUNY Stony Brook Stony Brook NY USA 11794 oped, Stony Brook, NY 11794 USA
Titolo Testata:
ACADEMIC EMERGENCY MEDICINE
fascicolo: 1, volume: 8, anno: 2001,
pagine: 74 - 77
SICI:
1069-6563(200101)8:1<74:EFPSPT>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
EMERGENCY; CHILDREN; ANESTHESIA; MIDAZOLAM; ANALGESIA;
Keywords:
etomidate; procedural sedation; pediatrics; fractures;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Singer, AJ SUNY Stony Brook, Univ Med Ctr L4 515, Dept Emergency Med, Stony Brook, NY11794 USA SUNY Stony Brook Stony Brook NY USA 11794 y Brook, NY11794 USA
Citazione:
R. Dickinson et al., "Etomidate for pediatric sedation prior to fracture reduction", ACAD EM MED, 8(1), 2001, pp. 74-77

Abstract

Objective: While etomidate is reported as a procedural sedative in adults,its use in children has not been extensively reported. The authors describe their experience with etomidate for procedural sedation in children with extremity fractures and major joint dislocations. Methods: This was a retrospective descriptive chart review. The setting was a university-based emergency department (ED) that follows national guidelines for procedural sedation. Subjects were children less than 18 years old who received etomidate prior to fracture reduction or major joint dislocations. Standardized data were abstracted from the medical records, including patient demographics, diagnosis, weight, types and doses of sedative and analgesic agents used, number of boluses of etomidate, attempts at reduction, complications encountered, vitals signs before, during, and after the reduction, disposition, and the time from procedure to discharge. Descriptive statistics calculated included means and proportions with 95% confidence intervals. Results: Fifty-three children received etomidate for fracture reduction. Their mean age was 9.7; 41.5% were females. Indications for reduction included forearm fractures (38), ankle fractures (12), upper arm fractures (2), and hip dislocations (1). In most cases (83%) reduction was successful after one attempt only. The mean initial and total doses of etomidate were 0.20 mg/kg (range, 0.1 to 0.4) and 0.24 mg/kg (range, 0.13 to 0.52), respectively. Thirteen patients required a second bolus of etomidate or midazolam. Thirty-four patients (64%) were discharged from the ED after a mean observation of 94 minutes (range, 35 to 255). There were no major adverse events (95% CI = 0% to 5.1%). One patient reported nausea and one required a fluid bolus for hypotension. One patient receiving multiple sedatives and opioid analgesics was admitted for observation due to prolonged sedation. No patient required assisted ventilation or intubation. Conclusions: These results suggest that etomidate is a safe and effective agent for procedural sedation in children requiring fracture and major joint reductions.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 08:56:28