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Introduction of a LAT gel and low-dose midazolam sedo-analgesia protocol for pediatric skin suture in the emergency department: simpler is better.
Intern Emerg Med
December 2024
Centro EAS, Emergency Department, Papa Giovanni XXIII Hospital, Piazza OMS, 1, 24127, Bergamo, BG, Italy.
Background: skin lacerations are one of the main causes of children's referral to the emergency department (ED). We introduced in our general ED a pediatric sedo-analgesia protocol (SAP) for suturing skin wounds using LAT gel, a local anesthetic solution of lidocaine, adrenaline and tetracaine, with or without low-dose oral midazolam according to patient's age, to improve the experience of laceration repair.
Methods: Primary outcomes were improvement of suturing experience for ED operators (as a reduction in the desire to avoid the procedure) and of the adequacy of sedo-analgesia provided, investigated through two different surveys administered to the ED staff before and after the introduction of the SAP.
In-Hospital Outcomes of Neonates with Hypoxic-Ischemic Encephalopathy Receiving Sedation-Analgesia during Therapeutic Hypothermia.
Am J Perinatol
November 2024
Division of Neonatology, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania.
Objective: This study aimed to compare magnetic resonance imaging (MRI) severity scores and in-hospital outcomes among neonates with perinatal hypoxic-ischemic encephalopathy (HIE) with and without exposure to sedation-analgesia (SA) during therapeutic hypothermia (TH).
Study Design: A single-center, retrospective cohort study of neonates with perinatal HIE undergoing TH between January 2010 and December 2020. Demographics, clinical characteristics, MRI scores, and in-hospital outcomes were compared between patients without SA exposure and those with SA use.
Sedation - analgesia - muscle relaxant - withdrawal and delirium practices in pediatric intensive care units in Türkiye.
Turk J Pediatr
November 2024
Department of Pediatric Intensive Care Unit, Cukurova University Faculty of Medicine, Adana, Türkiye.
Background: Pain and sedation management is an integral part of pediatric intensive care practice. Sedoanalgesia management must be balanced in order to optimize comfort and avoid complications. In order to achieve this balance, sedoanalgesia management needs to be clarified in pediatric intensive care units (PICU).
View Article and Find Full Text PDFTrends in analgesia-sedation of pediatric patients receiving I-131 MIBG in the pediatric intensive care unit: A report from the Pediatric Health Information System database.
Pediatr Blood Cancer
October 2024
Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
Article Synopsis
- A study analyzed sedation-analgesia trends in children with neuroblastoma receiving I-131 MIBG therapy, using data from the Pediatric Health Information System (PHIS) over a 9-year period (2010-2019).
- Among 476 patient encounters, results showed a notable decrease in the use of benzodiazepines and opioids, while the use of ketamine and dexmedetomidine increased, particularly in younger patients.
- The findings indicate a shift in sedation practices, highlighting variability in medication choices and suggesting a movement towards less reliance on traditional sedatives like benzodiazepines and opioids.
Phenobarbital as a Sedation Strategy to Reduce Opioid and Benzodiazepine Burden in Neonatal Extracorporeal Membrane Oxygenation.
Am J Perinatol
August 2024
Division of Neonatology, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania.
Objective: The study aims to describe our experience with the implementation of phenobarbital as a primary sedation strategy during neonatal extracorporeal membrane oxygenation (ECMO).
Study Design: Retrospective chart review in a level IV neonatal intensive care unit between 2011 and 2021 comparing neonatal ECMO patients before and after the implementation of a sedation-analgesia (SA) protocol using scheduled phenobarbital as the primary sedative. Groups were compared for neonatal and ECMO characteristics, cumulative SA doses, and in-hospital outcomes.
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