Non-Intravenous Sedatives and Analgesics for Procedural Sedation for Imaging Procedures in Pediatric Patients

Abstract

OBJECTIVES:The purpose of this study was to describe the method of delivery, dosage regimens, and outcomes of sedatives administered by extravascular route for imaging procedures in children. METHODS: Medline, Embase, International Pharmaceutical Abstracts, and Cochrane Database of Systematic Reviews were searched using keywords "child", "midazolam", "ketamine", dexmedetomidine", "fentanyl", "nitrous oxide", and "imaging. " Articles evaluating the use of extravascular sedation in children for imaging procedures published in English between 1946 and March 2015 were included. Two authors independently screened each article for inclusion. Reports were excluded if they did not contain sufficient details on dosage regimens and outcomes. RESULTS: Twenty reports representing 1,412 patients ranging in age from 0.33 to 19 years of age were included for analysis. Due to discrepancies in doses and types of analyses, statistical analyses were not performed.

Sedation and Analgesia Using Medications Delivered via the Extravascular Route in Children Undergoing Laceration Repair

“…21 N 2 O is also inhaled as a gas mixture with oxygen, and hence has a very quick onset time, but children younger than 5 years may not tolerate the use of a facemask, which is needed to ef-fectively deliver the gas mixture. 22 However, 3 studies included in our review showed acceptable tolerance for children as young as 3 years, and the quick onset may offset any tolerability issues. 6,14,15 Rectal administration may be poorly tolerated because of the perceived invasive delivery.…”

Comparison of the effects of intranasal and intramuscular administrations of zolazepam–tiletamine combination on intraocular pressure in cats

“…In human medicine, IN administration of sedative drugs has been shown to be safe and effective due to rapid absorption of the drugs from the olfactory epithelium to the brain . Although to the best of our knowledge, no study has evaluated the effects of IN administration of anesthetics on IOP, it has been previously demonstrated that IN and IM administrations of steroids have similar effect on IOP regardless of administration route .…”

Influences of dexmedetomidine on stress responses and postoperative cognitive and coagulation functions in patients undergoing radical gastrectomy under general anesthesia

“…Optimization of anesthesia strategy can help reduce postoperative adverse events in patients undergoing RG for GC, with a certain protective effect on vital organ functions and postoperative CF[ 8 , 9 ]. Dexmedetomidine (DEX) is a multipotent central α-2 adrenergic agonist with sedative, analgesic, and anti-sympathetic functions, which is often used as an anesthetic adjuvant[ 10 ]. It is used in a wide range of clinical scenarios.…”