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Unconscious sedation in children: a prospective multi-arm clinical trial
Loren A Bauman1, Michael L Cannon, John McCloskey
1Department of Anesthesiology, Section of Pediatric Anesthesiology and Critical Care Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA. lbauman@wfubmc.edu
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.