Gama-hidroxibutirato para a sedação de crianças

Abstract

We read with interest the article by Mencia et al. on analgesia and sedation in children.1 In addition to the plethora of drugs discussed by the authors, we would like to add our experience on the use of gamma-hydroxybutyrate (GHB) for sedation in children. 2 In our prospective randomized trial, we showed that GHB induces deep sedation (Ramsay score 5) in children undergoing MRI studies. GHB was associated with vomiting despite the prior administration of an antiemetic. This may in part be attributable to the fact that GHB sedation was used in pediatric cancer patients, making them more prone to this side effect because of concurrent chemo-and radiotherapy.Although none of our GHB-sedated patients aspirated during the study, the physician should be aware of this possibility.Moreover, none of our patients required administration of physostigmine, a short-acting anticholinesterase agent, to treat prolonged sedation.We conclude that GHB sedation is a reasonable alternative for children undergoing noninvasive diagnostic procedures. Pediatricians that are not familiar with potent short-acting sedative drugs (propofol, remifentanyl, etc.) may consider it for deep sedation in pediatric patients. doi:10.2223/JPED.1685 S. MeyerThe Centre for Newborn Care, Medical School, The Canberra Hospital, Australian National University, Canberra, Australia. S. GottschlingDepartment of Pediatrics and Neonatology, University Hospital of the Saarland, Saarbrücken, Germany. L. GortnerDepartment of Pediatrics and Neonatology, University Hospital of the Saarland, Saarbrücken, Germany. Authors' replyWe read with interest the comments made by Dr. S. Meyer Dexmedetomidine sedation delivered by pediatricians is rapidly increasing and has provided adequate sedation in most children. Dexmedetomidine could be an alternative reliable sedative drug in selected patients because it causes fewer cardiorespiratory effects. 4 Similarly, nitrous oxide for pediatric sedation, while promising, will require careful study 386