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Effects of initial pain treatment on sedation recovery time in pediatric emergency care

Joseph D Losek1, Samuel Reid

  • 1Department of Pediatrics, Medical University of South Carolina Children's Hospital, Charleston, SC, USA. losek@musc.edu

Pediatric Emergency Care
|February 17, 2006
PubMed

Insights

Adding initial pain treatment like morphine or meperidine to ketamine/midazolam (K/M) sedation in children significantly increases recovery time. Meperidine resulted in the longest sedation recovery for pediatric patients.

Area of Science:

  • Pediatric Emergency Medicine
  • Pharmacology
  • Sedation Analgesia

Background:

  • Procedural sedation analgesia is common in pediatric emergency departments.
  • Ketamine/midazolam (K/M) is a frequently used combination for sedation.
  • The impact of concurrent pain management on K/M recovery time requires further investigation.

Purpose of the Study:

  • To compare sedation recovery times in children receiving ketamine/midazolam (K/M) alone versus K/M with initial pain treatment (morphine or meperidine).

Main Methods:

  • Retrospective cross-sectional study in a pediatric emergency department.
  • Included children receiving K/M for procedural sedation analgesia.
  • Data collected via uniform data collection forms.

Main Results:

  • 80 children met inclusion criteria; 33 received K/M only, 32 received K/M with morphine, and 15 received K/M with meperidine.
  • No significant difference in K/M dosage (mg/kg) across groups.
  • Sedation recovery times were significantly longer for K/M with morphine (41.1 min) and K/M with meperidine (50.1 min) compared to K/M only (29.7 min).

Conclusions:

  • Initial pain treatment with morphine or meperidine significantly prolongs K/M sedation recovery time in children.
  • Meperidine was associated with the longest sedation recovery time.
  • Recommend against using meperidine for initial pain treatment in pediatric emergency sedation due to prolonged recovery and adverse effects.
Abstract

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