Sedative-analgesic agent administration in children: analysis of use and complications in the emergency department.
The frequency of, indications for, and complications from non-acetaminophen sedative-analgesic agents (SAAs) administered to children less than 16 years of age in the emergency department (ED) were determined by a retrospective review. All 21,353 charts from a single university hospital ED over a 16-month period were included. Few children (N = 759; 3.5%) received SAAs. Of 919 total doses, 13% of children received a second and 4.5% received a third SAA. The group was 59% male. Most children were < or = 10 years of age. Sixty-two percent of SAAs were either sedatives or opioids. Sedatives given included chloral hydrate, diazepam, lorazepam, midazolam, and phenobarbital. Opioids given included morphine, codeine, and meperidine. Indications for SAAs included painful procedures, analgesia, radiographic imaging, and seizure activity. Complications (N = 51; 6.7%) included inadequate sedation, vomiting, and respiratory depression or oxygen desaturation. Respiratory depression or oxygen desaturation occurred only after intravenous administration of SAAs for seizures. In children, non-acetaminophen SAAs are used most commonly in younger patients requiring sedation for painful procedures or for radiologic imaging. Respiratory depression was observed only after intravenous administration of anticonvulsants.
Department of Pediatrics and Surgery, Medical College of Georgia, Augusta.
D J
DJ
Woolard
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Terndrup
D000700:Analgesics / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D017723:Drug Utilization Review; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007223:Infant; D008297:Male; D012131:Respiratory Insufficiency / Q000139:chemically induced; D012189:Retrospective Studies
D000700:Analgesics; D000927:Anticonvulsants; D006993:Hypnotics and Sedatives