Sedación y analgesia para procedimientos invasivos en los niños

M., Loreto Godoy; A, Paola Pino; L., Gulliana Córdova; O, Juan Andrés Carrasco; M, Andrés Castillo

doi:10.5546/aap.2013.22

Cited by 6 publications

(6 citation statements)

References 26 publications

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“…Therefore, additional doses of ketamine are preferred. In some previous studies with midazolam and ketamine the incidence of oxygen desaturation was between 4.8% and 12%, whereas Ozdemir et al reported no oxygen desaturation [ 7 , 13 , 14 , 15 , 16 ]. In the present study none of the patients’ oxygen saturation dropped below 90%.…”

Section: Discussionmentioning

confidence: 99%

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The Efficacy and Safety of Procedural Sedoanalgesia with Midazolam and Ketamine in Pediatric Hematology

Gelen¹,

Sarper²,

Demırsoy³

et al. 2015

Tjh

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Objective:The aim of this study is to investigate the efficacy and safety of sedoanalgesia performed outside the operating room by pediatricians trained in advanced airway management and life support.Materials and Methods:Midazolam and ketamine were administered consecutively by intravenous route under cardiorespiratory monitoring for painful procedures of pediatric hematology.Results:A total of 115 patients had 237 sedoanalgesia sessions. Sedation time was 24.02±23.37 s and sedation success was 92.5% (Ramsay scores of ≥5). Patient satisfaction was high. The recovery time was 28.81±14.4 min. Although statistically significant (p<0.01) increases in systolic and diastolic blood pressure, heart rate, and respiratory rate were observed without clinical importance, they improved without any intervention. No severe adverse events were observed.Conclusion:Sedoanalgesia with intravenous midazolam and ketamine for pediatric hematology and oncology patients’ painful minor invasive procedures performed in an optimally equipped setting outside the operating room by pediatricians trained and certificated in advanced airway management and life support is effective and safe.

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Section: Discussionmentioning

confidence: 99%

“…In the present study none of the patients’ oxygen saturation dropped below 90%. Compared to propofol, the combination of ketamine and midazolam was associated with less hypoxemia [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy and Safety of Procedural Sedoanalgesia with Midazolam and Ketamine in Pediatric Hematology

Gelen¹,

Sarper²,

Demırsoy³

et al. 2015

Tjh

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“…In our institution, ketamine in combination with midazolam was chosen to induce anesthesia in majority of operations according to some literatures that have shown that this combination has a low rate of complication and a shorter recovery time (10,11). In 140 of operations this combination was enough to obtain deep sedation.…”

Section: Discussionmentioning

confidence: 99%

Safety of Deep Sedation with General Anesthesia for Minor Invasive Procedures in Pediatric Hematology/Oncology Patients

Tüysüz

Tayfun

2018

Iran J Pediatr

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Background: Multiple invasive procedures are routinely performed in diagnosis and treatment of hematologic/oncologic diseases. Because these procedures are painful, they may cause stress and anxiety in patients and their parents. Especially in patients with malignancies, the repeating procedures can lead to psychiatric disorders like depression and post-traumatic stress disorders. Therefore, general anesthesia is recommended during these invasive procedures for pain control. Objectives: The goal of this study was to evaluate safety and outcome of deep sedation with general anesthesia in hematology/oncology patients during invasive interventions in pediatric outpatient sedation unit. Methods: We retrospectively analyzed records of 129 patients (59 girls and 70 boys) who had undergone 155 invasive procedures with general anesthesia. Patient demographics, reason of operations, anesthesia complications, duration of procedures, and time for recovery from anesthesia were recorded from anesthesia charts. Patients received ketamine (maximum dosage 2 mg/kg) plus midazolam, ketamine plus midazolam plus sevoflurane inhaler (sevoflurane inhaler was added when 2 mg/kg of ketamine was inadequate to obtain deep sedation) and sevoflurane inhaler in 140, 10 and 5 of operations, respectively. Results: Complications occurred in 31 (20%) of these operations. Majority of complications were mild and included post-op agitation, vomiting and local pain which occurred in 6, 5 and 4 of the operations, respectively. Only 2 patients developed severe complications (fall off the stretcher and bronchospasm) which did not lead to any long term morbidity. The complication rate did not differ according to the anesthetic drugs, reason of operations or patient demographics. Conclusions: In this group of patients, deep sedation with general anesthesia in an outpatient sedation unit, administered by trained professionals, was safe, quick, and effective for short-term invasive painful procedures.

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“…52 Para los procedimientos invasivos de corta duración, las drogas de elección son la ketamina y el midazolam. 49,50,53 El propofol se prefiere en los procedimientos cortos para los pacientes que requieren evaluación neurológica frecuente, como pacientes con TEC o en estado convulsivo. 46,50 Sin embargo, existe cada vez más evidencia de que infusiones prolongadas no conllevan efectos adversos.…”

Section: Sedación Analgesia Y Bloqueantes Neuromuscularesunclassified

Consenso sobre el traslado de niños críticamente enfermos Comité Nacional de Emergencias y Cuidados Críticos

2019

Arch Argent Pediat

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Comité Nacional de Emergencias y Cuidados Críticos* RESUMEN El mayor desarrollo y la creación de nuevas unidades de terapia intensiva pediátrica en los últimos años obligan a revisar la estructuración adecuada de los cuidados correspondientes entre la reanimación inicial del paciente grave y la atención por especialistas en ámbitos de alta complejidad. El proceso de transporte debe ofrecer al paciente grave un estándar de cuidado similar al que se le ofrece en dicha Unidad. Este se logra con un equipo entrenado en el transporte pediátrico y con capacidad de proveer cuidados críticos. La decisión de transportar a un paciente dentro del mismo hospital o a otra institución se basa en la evaluación de los potenciales beneficios sopesados contra potenciales riesgos, ya que existe un incremento de la morbilidad y la mortalidad durante el transporte. Las recomendaciones que se presentan en este documento tienen el objetivo de intentar mejorar el traslado de pacientes críticos en nuestro país. Palabras clave: transportes, pediatría, cuidados críticos, transferencia de pacientes.

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Sedación y analgesia para procedimientos invasivos en los niños

Cited by 6 publications

References 26 publications

The Efficacy and Safety of Procedural Sedoanalgesia with Midazolam and Ketamine in Pediatric Hematology

The Efficacy and Safety of Procedural Sedoanalgesia with Midazolam and Ketamine in Pediatric Hematology

Safety of Deep Sedation with General Anesthesia for Minor Invasive Procedures in Pediatric Hematology/Oncology Patients

Consenso sobre el traslado de niños críticamente enfermos Comité Nacional de Emergencias y Cuidados Críticos

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