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Efficacy and safety of a diazepam and meperidine combination for pediatric gastrointestinal procedures
M C Nahata1, R D Murray, J Zingarelli
1College of Pharmacy, Ohio State University, Columbus 43210.
Insights
Diazepam and meperidine effectively sedated pediatric patients for outpatient procedures like endoscopy. This combination demonstrated safety with minimal adverse effects and good patient cooperation.
Area of Science:
- Pediatric Gastroenterology
- Sedation Management
- Ambulatory Care
Background:
- Limited research exists on outpatient sedation for pediatric patients.
- Sedation is crucial for pediatric procedures like endoscopy, colonoscopy, and liver biopsy.
Purpose of the Study:
- To evaluate the efficacy and safety of combined diazepam and meperidine for sedation in pediatric outpatients.
- To assess adverse effects and patient outcomes during and after gastrointestinal procedures.
Main Methods:
- A study involving 30 pediatric patients (7 months-20 years) receiving intravenous diazepam and meperidine.
- Standard doses were 0.1 mg/kg diazepam and 2.0 mg/kg meperidine, with weight-based adjustments.
- Evaluated sedation onset, vital signs, cooperation, emotional state, drowsiness, amnesia, and adverse events.
Main Results:
- Diazepam and meperidine combination was effective in 26 of 30 patients, achieving sedation within 2-3 minutes.
- Significant improvements in cooperation and emotional state were observed post-administration (p < 0.05).
- A follow-up study of 40 patients revealed no significant adverse effects, with 20% amnesia in older children.
Conclusions:
- Combined diazepam and meperidine is effective and safe for sedating pediatric patients undergoing gastrointestinal procedures.
- Prolonged post-procedure monitoring may not be necessary for this patient group.
- This sedation regimen supports safe and efficient ambulatory pediatric care.
Abstract:
Little has been published about outpatient sedation for pediatric patients. We designed a study to evaluate the efficacy and adverse effects of diazepam and meperidine in combination for sedation in ambulatory pediatric patients undergoing endoscopy, colonoscopy, or liver biopsy. Thirty patients (7 months-20 years) were observed. Each patient received a single combined dose of intravenous diazepam and meperidine. The standard dose was 0.1 mg/kg for diazepam and 2.0 mg/kg for meperidine. In patients weighing greater than 100 lb, set doses of meperidine (100 mg) and diazepam (5 mg) were used. The time to achieve sedation and the vital signs were measured; cooperation, emotional state, and drowsiness were rated before, during, and after procedures. The amnesic effect was noted, as were any adverse effects. Diazepam and meperidine were effective in 26 of 30 patients, with sedation generally produced within 2-3 min. Cooperation and emotional state improved significantly following drug administration (p less than 0.05). When a prospective 24-h telephone follow-up study was instituted in 40 consecutive patients receiving diazepam and meperidine no significant adverse effects were noted. Only 20% of patients old enough to be questioned remembered the procedure. Diazepam and meperidine in combination appear to be effective and safe in pediatric patients undergoing gastrointestinal procedures. Prolonged monitoring of patients does not appear necessary in this patient population.