Procedural sedation for insertion of central venous catheters in children: comparison of midazolam/fentanyl with midazolam/ketamine

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dc.contributor.authorSilva, Paulo Sergio Lucas da
dc.contributor.authorIglesias, Simone Brasil de Oliveira [UNIFESP]
dc.contributor.authorAguiar, Vania Euzebio
dc.contributor.authorCarvalho, Werther Brunow de
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T12:42:04Z
dc.date.available2016-01-24T12:42:04Z
dc.date.issued2007-04-01
dc.description.abstractBackground: There is a lack of studies evaluating procedural sedation for insertion of central venous catheters (CVC) in pediatric patients in emergency departments or pediatric intensive care units (PICU). This study was designed to evaluate whether there is a difference in the total sedation time for CVC insertion in nonintubated children receiving two sedation regimens.Methods: Patients were prospectively randomized to receive either midazolam/fentanyl (M/F) or midazolam/ketamine (M/K) i.v. the Children's Hospital of Wiscosin Sedation Scale was used to score the sedation level.Results: Fifty seven patients were studied (28 M/F and 29 M/K). Group M/F received midazolam (0.24 +/- 0.11 mg.kg(-1)) and fentanyl (1.68 +/- 0.83 mu g.kg(-1)) and group M/K received midazolam (0.26 +/- 0.09 mg.kg(-1)) and ketamine (1.40 +/- 0.72 mg.kg(-1)). the groups were similar in age, weight, risk classification time and sedation level. Median total sedation times for M/F and M/K were 97 vs 105 min, respectively (P = 0.67). Minor complications occurred in 3.5% (M/F) vs 20.7% (M/K) (P = 0.03). M/F promoted a greater reduction in respiratory rate (P = 0.005).Conclusions: in this study of nonventilated children in PICU undergoing central line placement, M/F and M/K provided a clinically comparable total sedation time. However, the M/K sedation regimen was associated with a higher rate of minor complications. A longer period of study is required to assess the efficacy and safety of these sedative agents for PICU procedures in nonintubated children.en
dc.description.affiliationHosp Serv Publ Municipal São Paulo, Dept Pediat, Pediat Intens Care Unit, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent358-363
dc.identifierhttp://dx.doi.org/10.1111/j.1460-9592.2006.02099.x
dc.identifier.citationPediatric Anesthesia. Oxford: Blackwell Publishing, v. 17, n. 4, p. 358-363, 2007.
dc.identifier.doi10.1111/j.1460-9592.2006.02099.x
dc.identifier.issn1155-5645
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/29648
dc.identifier.wosWOS:000244742900009
dc.language.isoeng
dc.publisherBlackwell Publishing
dc.relation.ispartofPediatric Anesthesia
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectcentral venous catheteren
dc.subjectprocedural sedationen
dc.subjectmidazolamen
dc.subjectfentanylen
dc.subjectketamineen
dc.titleProcedural sedation for insertion of central venous catheters in children: comparison of midazolam/fentanyl with midazolam/ketamineen
dc.typeinfo:eu-repo/semantics/article
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