Navegando por Palavras-chave "procedural sedation"

Agora exibindo 1 - 2 de 2
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Procedural sedation for insertion of central venous catheters in children: comparison of midazolam/fentanyl with midazolam/ketamine
    (Blackwell Publishing, 2007-04-01) Silva, Paulo Sergio Lucas da; Iglesias, Simone Brasil de Oliveira [UNIFESP]; Aguiar, Vania Euzebio; Carvalho, Werther Brunow de; Universidade Federal de São Paulo (UNIFESP)
    Background: There is a lack of studies evaluating procedural sedation for insertion of central venous catheters (CVC) in pediatric patients in emergency departments or pediatric intensive care units (PICU). This study was designed to evaluate whether there is a difference in the total sedation time for CVC insertion in nonintubated children receiving two sedation regimens.Methods: Patients were prospectively randomized to receive either midazolam/fentanyl (M/F) or midazolam/ketamine (M/K) i.v. the Children's Hospital of Wiscosin Sedation Scale was used to score the sedation level.Results: Fifty seven patients were studied (28 M/F and 29 M/K). Group M/F received midazolam (0.24 +/- 0.11 mg.kg(-1)) and fentanyl (1.68 +/- 0.83 mu g.kg(-1)) and group M/K received midazolam (0.26 +/- 0.09 mg.kg(-1)) and ketamine (1.40 +/- 0.72 mg.kg(-1)). the groups were similar in age, weight, risk classification time and sedation level. Median total sedation times for M/F and M/K were 97 vs 105 min, respectively (P = 0.67). Minor complications occurred in 3.5% (M/F) vs 20.7% (M/K) (P = 0.03). M/F promoted a greater reduction in respiratory rate (P = 0.005).Conclusions: in this study of nonventilated children in PICU undergoing central line placement, M/F and M/K provided a clinically comparable total sedation time. However, the M/K sedation regimen was associated with a higher rate of minor complications. A longer period of study is required to assess the efficacy and safety of these sedative agents for PICU procedures in nonintubated children.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Use of Ketofol for procedural sedation and analgesia in children with hematological diseases
    (Wiley-Blackwell, 2011-02-01) Lucas da Silva, Paulo Sergio; Aguiar, Vania Euzebio de; Waisberg, Daniel Reis; Augusto Passos, Roselene M.; Flor Park, Miriam Veronica; Hosp Brigadeiro; Universidade Federal de São Paulo (UNIFESP)
    Background:The aim of this study was to evaluate the effectiveness and safety of intravenous ketamine-propofol admixture (ketofol) in the same syringe for procedural sedation and analgesia in children undergoing bone marrow aspiration.Methods:This was a prospective, observational pilot study. Patients aged between 4 and 12 years requiring sedation for bone marrow aspiration were included. Ketofol (1 : 1 mixture of ketamine 10 mg/mL and propofol 10 mg/mL) was given intravenously in 0.5 mg/kg aliquots each with a 1-min interval and titrated to reach sedation levels of 3 or 4 (Ramsay score). the primary outcome was patient satisfaction with the degree of sedation. Secondary outcomes included injection pain, total sedation time, recovery time, hemodynamic and respiratory parameters, and adverse events.Results:A total of 20 patients were enrolled in the study. the median total dose of ketofol administered was 1.25 mg/kg each of propofol and ketamine (95%CI 0.77-2 mg/kg). the median score on the visual analog scale was 0 (extremely comfortable) (0-1.5; 95%CI 0.2-2.2). Median recovery time was 23 min (20.5-28 min; 95%CI 17.1-51.2). the incidence of injection pain was 2/20. Two patients had transient diplopia and one child reported dreams. No patients had hypotension, vomiting or required airway intervention.Conclusion:Ketofol provided effective sedation, which was reflected in the high degree of satisfaction recorded by children requiring procedural sedation and analgesia for bone marrow aspiration. We also observed rapid recovery and no clinically significant complications. A large number of patients is required to evaluate and validate these findings.