Consigning "brutacaine" to history: a survey of pharmacological techniques to facilitate painful procedures in children in emergency departments in the UK

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

“…This is in contrast to reported UK practice in which midazolam was reported as the most frequently used agent 21. Although a useful sedative, anxiolytic and amnestic agent,1 midazolam in the ED setting is hampered by a lack of analgesic properties.…”

“…UK data on actual sedation practices in EDs are limited 19–21. A national survey in UK EDs21 found that midazolam was the most widely used agent for procedural sedation followed by ketamine. Nitrous oxide was not reported as an agent used; as the actual survey was not included it is not clear if nitrous oxide was not used in EDs or questions about nitrous oxide had not been included in the survey.…”

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

“…In the past, inadequate management of pain was common, including physical restraint of a struggling child (so‐called ‘brutaine’). It has become increasingly recognised that children often require sedation for these procedures …”

Topical anaesthesia in children: reducing the need for specialty referral

“…Despite this, a significant proportion of lacerations still require suturing because of their location, size, depth or width [1,4,5]. The physical restraint of struggling children during painful procedures, such as laceration repair, termed 'brutacaine', should no longer be an acceptable part of modern practice [6]. Sedation and general anaesthesia act to minimize pain and distress, while maximizing amnesia and patient safety [7].…”