Related Experiment Videos
Procedural sedation for fracture reduction in children with hyperactivity
Betsy L Schmerler1, Daniel M Cohen, Marc S Leder
1Department of Pediatrics, Division of Pediatric Emergency Medicine, Columbus Children's Hospital, Columbus, OH 43205, USA. schmerlerb@pediatrics.ohio-state.edu
The American Journal of Emergency Medicine
|July 9, 2008
Summary
Children with attention-deficit/hyperactivity disorder (ADHD) required similar procedural sedation dosages as controls. However, their emergency department visits and sedation durations were longer, suggesting further investigation is needed for ADHD procedural sedation.
Area of Science:
- Pediatric Emergency Medicine
- Pharmacology
- Neurodevelopmental Disorders
Background:
- Children with attention-deficit/hyperactivity disorder (ADHD) experience more severe injuries.
- ADHD may alter responses to procedural sedation.
- Understanding sedation differences is crucial for effective pediatric care.
Purpose of the Study:
- To compare procedural sedation in children with and without ADHD.
- To evaluate sedation efficacy and safety in pediatric ADHD patients.
- To identify potential differences in sedation requirements for ADHD patients.
Main Methods:
- Retrospective study of 44 children with ADHD and 41 controls.
- Sedation administered using fentanyl and midazolam for forearm fracture reduction.
- Comparison of drug dosages, vital signs, and sedation scores.
Main Results:
- No significant differences in drug dosages, vital signs, or sedation scores between groups.
- Mean emergency department visit duration was significantly longer for children with ADHD.
- Sedation duration was also significantly longer in children with ADHD.
Conclusions:
- Children with and without ADHD achieved similar sedation levels with equivalent total drug dosages.
- Extended sedation and visit durations in ADHD patients warrant further investigation.
- These findings highlight potential differences in sedation management for pediatric ADHD patients.
Related Concept Videos
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
01:27Fractures: Bone Repair
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:31Skeletal Muscle Relaxants: Therapeutic Uses
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
01:22Stages of General Anesthesia
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
01:23Sedatives and Hypnotics: Overview
Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...