Paediatric procedural sedation based on nitrous oxide and ketamine: sedation registry data from Australia

Abstract

In variation to reported practice elsewhere, almost all procedures in this Australian series were undertaken using nitrous oxide and ketamine. The serious adverse events rate was low.

Procedural Sedation by Pediatric Hospitalists: Analysis of the Nature and Incidence of Complications During Ketamine and Nitrous Oxide Sedation

“…There have been many studies illustrating the safe use of ketamine and N 2 O for procedural sedation by ED physicians and intensivists. [3][4][5][6][7] This is the fi rst study demonstrating the safe and effective use of ketamine and N 2 O by PH. It is important to note that a comprehensive sedation training program with anesthesia oversight and close collaboration with anesthesiologists is a key element of the PH sedation program at SLCH.…”

“…2 Several studies have demonstrated the safety of procedural sedation using ketamine and nitrous oxide (N 2 O) by emergency physicians and intensivists. [3][4][5][6][7] Pediatric intensivists and emergency physicians have been the primary nonanesthesiologist sedation providers because they have the greatest experience managing the pediatric airway in patients in the emergency department (ED) and ICU. However, pediatric hospitalists (PH) are increasingly providing sedation for various painful procedures and for radiologic imaging of children across the nation.…”

Perceptions of parents and paediatricians on pain induced by bone marrow aspiration and lumbar puncture among children with acute leukaemia: a qualitative study in China

“…59 A fixed nitrous oxide/ oxygen mixture can provide safe and effective analgesia for paediatric medical procedures. [60][61][62][63] Additionally, the equipment needed for its administration is relatively inexpensive, minimal training is required for operators and no additional resuscitation equipment or staff is needed. Thus, there is a need for the introduction of this inhalational analgesic and sedative agent in Chinese scientific literature to conserve medical resources.…”

Design and roll out of standardised approach to paediatric procedural sedation in Victorian emergency departments

“…Sedation has both benefits and risks. If managed well, it can be effective and safe, minimising pain and anxiety for patients and parents and providing optimum conditions for the safe completion of procedures . If managed poorly, it carries the risks of unconsciousness, suppression of vital protective airway reflexes and hypoventilation.…”

“…If managed well, it can be effective and safe, minimising pain and anxiety for patients and parents and providing optimum conditions for the safe completion of procedures. 3,4 If managed poorly, it carries the risks of unconsciousness, suppression of vital protective airway reflexes and hypoventilation. The keys to safe and successful treatment are case selection, having staff appropriately trained to administer sedation and having strong clinical governance arrangements, especially procedures, to maximise safety and effectiveness.…”