A comparison of intranasal sufentanil and midazolam to intramuscular meperidine, promethazine, and chlorpromazine for conscious sedation in children.
OBJECTIVE
To compare intranasal sufentanil and midazolam (IN-SM) with intramuscular meperidine, promethazine, and chlorpromazine (IM-MPC) for sedation in children.


METHODS
Single-blind, randomized, controlled study.


METHODS
Urban children's emergency department.


METHODS
A convenience sample of children aged 1 to 4 years requiring suturing.


METHODS
IN-SM or IM-MPC.


RESULTS
Vital signs, O2 saturation, and anxiety and pain scores were recorded. A 6-point scale was used to assess response to medication, and a 12-point recovery score was used to determine readiness for discharge. Both groups were similar in age and sex distribution. There were no significant adverse effects in either group. Patients tolerated the IN regimen better than the IM regimen. Behavioral scores were lower during repair than at baseline within each group; however, they were not different between groups. Time to discharge was longer and recovery scores were lower (worse) among the IM-MPC group.


CONCLUSIONS
IN-SM is as effective as IM-MPC for sedation in children.
Bates
B A
BA
Department of Pediatrics, Children's Medical Center of Dallas, Texas.
Schutzman
S A
SA
Fleisher
G R
GR
D000281:Administration, Intranasal; D001007:Anxiety / Q000517:prevention & control; D002652:Child Behavior / Q000187:drug effects; D002675:Child, Preschool; D002746:Chlorpromazine / Q000008:administration & dosage*; D016292:Procedural Sedation; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D008297:Male; D008614:Meperidine / Q000008:administration & dosage*; D008874:Midazolam / Q000008:administration & dosage*; D010147:Pain Measurement; D011398:Promethazine / Q000008:administration & dosage*; D016037:Single-Blind Method; D017409:Sufentanil / Q000008:administration & dosage*; D013537:Sutures; D014950:Wounds, Penetrating / Q000601:surgery
D004338:Drug Combinations; D008614:Meperidine; D017409:Sufentanil; D011398:Promethazine; D008874:Midazolam; D002746:Chlorpromazine