General and Safety Related Articles:
1)
Cote CJ, Notterman DA, Karl HW, Weinberg MD, McCloskey C. Adverse
Sedation Events in Pediatrics: A critical Incident analysis of contributing
factors. Pediatrics Vol. 105 No. 4 April 2000, pp. 805-14.
Comment: In what is sure to be a widely quoted study, Dr. Cote and coworkers
evaluated a data base which reported critical incidents regarding pediatric
sedation incidents over a ten year period. Of 115 cases identified for review, 95
met the criteria for analysis in this study. Various aspects of each case that
clearly contributed to the critical incident are included. The authors attempt to
look at systematic problems (obtained from this review) that should be changed
in order to avoid future sedation related critical incidents in children.
2)
Joseph MH, Brill J Lonnie KZ. Pediatric Pain Relief in Trauma. Pediatrics in
Review 1999;20, 75-84.
Comment: Sedations with analgesia were reviewed retrospectively (64 out of
247). Four minor complications were identified but none with any permanent
sequellae. Fentanyl with propofol infusion was found to have the quickest time to
recovery and discharge after the procedure.
3)
Morton NS et al. Development of a selection and monitoring protocol for
safe sedation of children. Paediatr Anesth. 1998;8(1):65-8.
4)
Cote CJ. Sedation for the pediatric patient. A review. Pediatr Clin North Am
1994 Feb;41(1):31-58.
5)
Conte PM Walco Ga. Procedural pain management in pediatric oncology: a
review of the literature. Cancer Investigation. 17 (6) 448-59, 1999.
6)
Macpherson CF, Lundblad LA: Conscious sedation of pediatric oncology
patients for painful procedures: development and implementation of a
clinical practice protocol. Journal of Pediatric Oncology Nursing. 14(1): 3342: 1997 Jan.
Comment: Protocol is included. A review of the literature is also included along
with 16 references.
7)
Schechter NL, Allen DA, Hanson K. Status of pediatric pain control: a
comparison of hospital analgesic usage in children and adults. Pediatrics
1986 77:11-15.
8)
Hart LS. Berns SD. Houck CS. Boenning DA. The value of end-tidal CO2
monitoring when comparing three methods of conscious sedation for
children undergoing painful procedures in the emergency department.
Pediatric Emergency Care. 13(3):189-93, 1997 Jun.
Comment: This paper looked at 40 patients randomly assigned to receive one of
three sedation medication regimens for painful procedures in the ED.
Capnography was used along with oxygen saturation to monitor respiratory
depression. The study found a surprisingly high rate of respiratory depression
when fentanyl was used as part of the medication scheme 20-23% and CO2 end
tidal monitoring allowed early detection of respiratory depression.
9)
Lowrie L. Weiss AH, Lacombe C: The pediatric sedation unit: a mechanism
for pediatric sedation. Pediatrics. 102(3) E30, 1998 September.
Comment: A controversial idea of centralized sedation with transport to site of
procedure by PICU nurses. This concept is proposed as a way to make sedation
uniform in a large hospital setting. Experience with 454 cases is reviewed.
Cancellation of procedures was required in 2.4% of cases due to decreased pulse
oximetry, airway obstruction, or apnea.
10) Warner TM. Clinical applications for pediatric sedation. CRNA. 1997
Nov;8(4) 144-51.
11) Egelhoff JC et al. Safety and efficacy of sedation in children using a
structured sedation program.
a. AJR Am J Roentgenol. 1997 May;168(5):1259-62.
12) Armstead VE. Pediatric sedative methods: an update. Anesthesia &
Analgesia. Suppl:1-5, 1998.
a. Mar.
13) Liebelt EL. Reducing pain during procedures. [Review] [22 refs] Current
Opinion in Pediatrics.
a. 8(5):436-41, 1996 Oct.
14) Malviya S et al. Adverse events and risk factors associated with the sedation
of children by non-anesthesiologists. Anesthesia & Analgesia 1997
Dec;85(6):1207-13.
15) Anghelescu D. Kaplan RF. Defining levels of sedation in pediatric patients
[letter; comment]. Anesthesia & Analgesia. 87(6):1454-5, 1998 Dec.
16) American Nurses Association. ANA position statements. The role of the
registered nurse in the management of patients receiving IV conscious
sedation for short-term therapeutic, diagnostic, or surgical procedures. SC1
Nurs. 1992;9:55-56.
17) D'Agostino J, Terndrup TE. Comparative review of the adverse effects of
sedatives used in children undergoing outpatient procedures. Drug Saf.
1996;14:146-157.
Comment: Authors comment on the ill-defined nature of deep vs. conscious
sedation in children under chloral hydrate sedation.
18) Zeigler VL. Brown LE. Conscious sedation in the pediatric population. Special
considerations. [Review] [49 refs] Critical Care Nursing Clinics of North
America. 9(3):381-94, 1997 Sep.
19) Tobias JD. Sedation and anesthesia for pediatric bronchoscopy. [Review]
[23 refs] Current Opinion in Pediatrics. 9(3):198-206, 1997 Jun.
Comment: A step by step description of the delivery of sedation ˆ starting with
the preoperative evaluation and ending with the recovery of the patient. Various
methods and drugs for sedation are described.
20) Balsells F. Wyllie R. Kay M. Steffen R. Use of conscious sedation for lower
and upper gastrointestinal endoscopic examinations in children,
adolescents, and young adults: a twelve-year review. Gastrointestinal
Endoscopy. 45(5):375-80, 1997 May.
Comment: A review of experience with 2711 sedations for endoscopy. The
authors review various methods and success rate and complication rate (0.3%).
They conclude that sedation is effective and necessary for endoscopy in children.