title: Unconscious sedation in children: a prospective multi-arm clinical trial.
abstract: 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.
authors.affiliation: 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
authors.forename: Loren A
authors.initials: LA
authors.lastname: Bauman
authors.forename: Michael L
authors.initials: ML
authors.lastname: Cannon
authors.forename: John
authors.initials: J
authors.lastname: McCloskey
authors.forename: Sharon
authors.initials: S
authors.lastname: Allen
authors.forename: Robert L
authors.initials: RL
authors.lastname: James
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Tobin
authors.forename: George D
authors.initials: GD
authors.lastname: Politis
mesh_terms: 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
chemical_list: D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D010880:Piperidines; D008723:Methohexital; D000077208:Remifentanil; D005283:Fentanyl; D015742:Propofol