Unconscious sedation in children: a prospective multi-arm clinical trial.
BACKGROUND
We report the evaluation of six sedative-hypnotic and analgesic combinations administered to children undergoing brief periods of unconscious (or deep) sedation for painful procedures.


METHODS
In a prospective, open-label, randomized, controlled study of six groups of 27-30 children each, patients were randomly assigned to receive propofol or methohexital for sedation-hypnosis, and one of three incremental doses of fentanyl or remifentanil, respectively.


RESULTS
An infusion of methohexital (10 mg.ml-1) combined with remifentanil (6.67 micro g.ml-1) provided significantly shorter geometric mean times to initial emergence, to eye-opening and to discharge, and required airway interventions that were not significantly more frequent than all groups sedated with propofol and fentanyl.


CONCLUSIONS
The combination of methohexital and remifentanil appears to be a satisfactory method for unconcious sedation for short painful procedures in children.
Bauman
Loren A
LA
Department of Anesthesiology, Section of Pediatric Anesthesiology and Critical Care Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA. lbauman@wfubmc.edu
Cannon
Michael L
ML
McCloskey
John
J
Allen
Sharon
S
James
Robert L
RL
Tobin
Joseph R
JR
Politis
George D
GD
D000762:Anesthesia Recovery Period; D019162:Anesthetics, Combined / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005283:Fentanyl / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008723:Methohexital / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D015742:Propofol / Q000627:therapeutic use; D011446:Prospective Studies; D000077208:Remifentanil; D014474:Unconsciousness
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D010880:Piperidines; D008723:Methohexital; D000077208:Remifentanil; D005283:Fentanyl; D015742:Propofol