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Deep sedation with methohexital or thiamylal with midazolam for invasive procedures in children with acute

Ming-Yun Hsieh1, Giun-Yi Hung, Yuh-Lin Hsieh

  • 1Department of Pediatrics, Taipei Veterans General Hospital Taipei, Taiwan.

Acta Paediatrica Taiwanica = Taiwan Er Ke Yi Xue Hui Za Zhi
|April 28, 2006
PubMed

Insights

Deep sedation using methohexital or thiamylal with midazolam is safe for pediatric acute lymphoblastic leukemia (ALL) patients undergoing invasive procedures. This approach effectively manages anxiety and ensures compliance in young children during treatments.

Area of Science:

  • Pediatric Oncology
  • Anesthesiology
  • Pharmacology

Background:

  • Pediatric oncology patients, particularly those with acute lymphoblastic leukemia (ALL), frequently require painful invasive procedures.
  • Deep sedation is often necessary for young children to manage anxiety and ensure cooperation during these interventions.

Purpose of the Study:

  • To evaluate the clinical safety and efficacy of methohexital or thiamylal combined with midazolam for deep sedation in children with ALL undergoing elective invasive procedures.

Main Methods:

  • A retrospective review of 20 pediatric patients with ALL who received deep sedation between November 1997 and March 2004.
  • Procedures included intrathecal therapy, with sedation administered using either methohexital or thiamylal alongside midazolam.
  • Dosages and adverse events were recorded for analysis.

Main Results:

  • A total of 176 procedures were performed, with 139 being intrathecal therapies.
  • One procedure failed due to bradycardia, hypotension, and cyanosis in the methohexital group; no other significant adverse events were noted.
  • Both sedation regimens resulted in increased heart rate with stable blood pressure.

Conclusions:

  • Methohexital or thiamylal combined with midazolam provides a safe deep sedation option for young pediatric ALL patients undergoing invasive procedures.
  • Careful monitoring and experienced practitioners are crucial for successful and safe sedation in this vulnerable population.

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