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. 2003 Oct;8(8):503-7.
doi: 10.1093/pch/8.8.503.

Procedural sedation and analgesia for paediatric patients in the emergency department

Lisa M Evered  1
Affiliations

Procedural sedation and analgesia for paediatric patients in the emergency department

Lisa M Evered. Paediatr Child Health. 2003 Oct.

Abstract
in English, French

Children presenting to the emergency department (ED) often require sedation for brief procedures such as fracture and dislocation reductions, laceration repairs, and imaging procedures that are painful, anxiety provoking or both. This article presents three cases of paediatric patients who require sedation and/or analgesia, and summarizes important aspects of procedural sedation for the primary care practitioner in the emergency setting. Presedation assessment and monitoring equipment are detailed. Discussion of routes of administration and different agents including barbiturates, opiates, benzodiaxepines, the 'cardiac coctail', ketamine, propofol, nitrous oxide, and etomidate follow. Emphasis is placed on indications, contraindications, dosing, timing and advantages and disadvantages of each. Reversal agents are mentioned, and discharge criteria are outlined.

Les enfants qui se présentent au département d’urgence (DU) ont souvent besoin de sédation pour subir de brèves interventions douloureuses, anxiogènes ou les deux, comme la réduction de fractures et de luxations, la réparation de lacérations et des interventions d’imagerie. Le présent article porte sur trois patients pédiatriques qui ont eu besoin de sédation ou d’analgésie et résume d’importants aspects de la sédation en cas d’intervention pour le praticien de première ligne à l’urgence. L’évaluation avant la sédation et le matériel de surveillance sont détaillés. Un exposé sur les voies d’administration et sur divers agents, y compris les barbituriques, les opiacés, les benzodiazépines, le « cocktail cardiaque », la kétamine, le propofol, l’oxyde nitreux et l’étomidate, suit. On fait ressortir les indications, les contre-indications, la posologie, la synchronisation et les avantages et inconvénients de chacun. Les agents d’inversion sont indiqués et les critères pour accorder le congé, soulignés.

Keywords: Analgesia; Emergency; Procedural sedation; Sedatives.

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References

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