A prospective analysis of intramuscular meperidine, promethazine, and chlorpromazine in pediatric emergency department patients.
OBJECTIVE
To examine physiologic responses and efficacy of 2, 1, and 1 mg/kg IM meperidine, promethazine, and chlorpromazine (MPC), respectively, in children.


METHODS
Prospective, unblinded trial.


METHODS
A university and community emergency department.


METHODS
Sixty-three hemodynamically and neurologically stable children.


METHODS
Single dose of IM MPC.


RESULTS
Serial respirations, heart rate, arterial systolic blood pressure, oxygen saturation, and Glasgow Coma Scale were measured at 30-minute intervals. Effectiveness was assessed by two independent observers using separate visual analog scales for cooperation and sedation. Times to sleep (27 +/- 24 minutes), sitting upright (103 +/- 87 minutes), ED discharge (4.7 +/- 2.4 hours), eating (11 +/- 7.9 hours), and normal behavior (19 +/- 15 hours) were acceptable. Minor, but statistically significant, changes in respiration rate (-1.9 +/- 0.4), heart rate (+4.5 +/- 1.8), oxygen saturation (-0.7 +/- 0.3%), and Glasgow Coma Scale (-2.5 +/- 0.6) occurred for 120 minutes after MPC. No serious complications or resuscitation were required. Mean visual analog scale scores were 5.0/10.4 or more in 71% of cases, with interobserver agreement very good (cooperation, r = .79; effectiveness, r = .80). Twenty-nine percent of children were judged insufficiently sedated.


CONCLUSIONS
IM MPC is a safe and generally effective agent for ED procedures in selected children.
Terndrup
T E
TE
Department of Critical Care & Emergency Medicine, State University of New York Health Science Center, Syracuse 13210.
Dire
D J
DJ
Madden
C M
CM
Davis
H
H
Cantor
R M
RM
Gavula
D P
DP
D000758:Anesthesia / Q000379:methods; D002648:Child; D002675:Child, Preschool; D002746:Chlorpromazine / Q000008:administration & dosage* / Q000009:adverse effects; D004341:Drug Evaluation; D004630:Emergencies; D005260:Female; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D008297:Male; D008614:Meperidine / Q000008:administration & dosage* / Q000009:adverse effects; D011398:Promethazine / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies
D008614:Meperidine; D011398:Promethazine; D002746:Chlorpromazine