Unconscious sedation in children: a prospective multi-arm clinical trial.

Author(s): Bauman LA, Cannon ML, McCloskey J, Allen S, James RL, Tobin JR, Politis GD

Affiliation(s): 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

Publication date & source: 2002-10, Paediatr Anaesth., 12(8):674-9.

Publication type: Clinical Trial; Randomized Controlled 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.