title: Procedural sedation for fracture reduction in children with hyperactivity.
abstract: OBJECTIVE
  Children with attention-deficit/hyperactivity disorder (ADHD) have a higher rate of more severe injuries than the general population. However, their ADHD may cause them to respond differently to procedural sedation required for treatment. The purpose of this article is to compare procedural sedation for children with and without ADHD.
  
  
  METHODS
  Retrospectively, 44 patients with ADHD and 41 controls sedated with fentanyl and midazolam for forearm-fracture reduction in the emergency department (ED) at a children's hospital were identified. Drug dosages, vital signs, and sedation scores were compared.
  
  
  RESULTS
  Drug dosages, vital signs, and sedation scores did not significantly differ between cases and controls. Mean ED visit duration was significantly longer for patients with ADHD than for controls as was sedation duration.
  
  
  CONCLUSIONS
  Children with and without ADHD were equally sedated with the same total drug dosages. The differences in sedation duration and visit duration warrant further investigation.
authors.affiliation: Department of Pediatrics, Division of Pediatric Emergency Medicine, Columbus Children's Hospital, Columbus, OH 43205, USA. schmerlerb@pediatrics.ohio-state.edu
authors.forename: Betsy L
authors.initials: BL
authors.lastname: Schmerler
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Cohen
authors.forename: Marc S
authors.initials: MS
authors.lastname: Leder
authors.forename: Bema K
authors.initials: BK
authors.lastname: Bonsu
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D016292:Procedural Sedation / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D005543:Forearm Injuries / Q000628:therapy; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000628:therapy*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000759:Adjuvants, Anesthesia; D006993:Hypnotics and Sedatives; D008874:Midazolam; D005283:Fentanyl