Etomidate versus ketamine effective use in emergency procedural sedation for pediatric orthopedic injuries
| Autor: | Hayri Levent Yilmaz, Akkan Avci, Nezihat Rana Dişel, Yasar Sertdemir, Hasan Yesilagac |
|---|---|
| Přispěvatelé: | Çukurova Üniversitesi |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Sedation Treatment outcome Joint Dislocations Pediatric emergency law.invention Sedation and analgesia Fractures Bone 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Fracture Fixation Etomidate law Humans Hypnotics and Sedatives Medicine Ketamine Prospective Studies 030212 general & internal medicine Child Adverse effect Prospective cohort study Orthopedic injuries business.industry 030208 emergency & critical care medicine General Medicine Fentanyl Treatment Outcome Anesthesia Pediatrics Perinatology and Child Health Orthopedic surgery Emergency Medicine Female Deep Sedation medicine.symptom Emergency Service Hospital business medicine.drug |
| Zdroj: | ResearcherID Web of Science |
| Popis: | PubMedID: 25834964 Objectives: The aim of this study was to compare the induction and recovery times, postsedation observation durations, and adverse effects of etomidate and ketamine in pediatric patients with fractures and/or dislocations requiring closed reduction in the emergency department. Methods: Forty-four healthy children aged 7 to 18 years were included. The patients were randomly divided into 2 groups. Group 1 (24 patients) received etomidate and fentanyl, and group 2 (20 patients) received ketamine intravenously. The Ramsay Sedation Scale and American Pediatric Association discharge criteria were used to evaluate the patients. Results: There were 70 fractured bones and 3 joint dislocations. Except in 1 case (2.3%), all of the injuries were reducted successfully. The mean amount of drugs used to provide adequate sedation and analgesia were 0.25 mg/kg of etomidate and 1.30 µ g/kg of fentanyl in group 1 and 1.25 mg/kg of ketamine in group 2. Fourteen patients (31.8%) reported adverse effects, and none required hospitalization. There was no difference between the groups in the recovery times, occurrence of adverse effects, and postsedation observation durations (P > 0.05). The mean (SD) induction time for the patients in group 1 was 4.3 (1.0) minutes, whereas it was 2.2 (1.6) minutes in group 2 (P < 0.001). Conclusions: Etomidate induces effective and adequate sedation in the pediatric emergency department for painful orthopedic procedures. Ketamine, which has longer action times, might be preferred for reductions because orthopedic procedures could be lengthy. © 2016 Wolters Kluwer Health, Inc. All rights reserved. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|