Intranasal fentanyl and high-concentration inhaled nitrous oxide for procedural sedation: A prospective observational pilot study of adverse events and depth of sedation

Academic Emergency Medicine

Volumn 19, Issue 1, 2012, Pages 31-36

  Seith, Robert W ^a,b   Theophilos, Theane ^a,c   Babl, Franz E ^a,c,d  

^a ROYAL CHILDREN'S HOSPITAL   (Australia)

^b MONASH MEDICAL CENTRE   (Australia)

^c MURDOCH CHILDREN'S RESEARCH INSTITUTE   (Australia)

^d UNIVERSITY OF MELBOURNE   (Australia)

Author keywords

[No Author keywords available]

Indexed keywords

FENTANYL; NITROUS OXIDE;

ADOLESCENT; ANALGESIA; ANESTHESIA LEVEL; ARTICLE; CHILD; CLINICAL ARTICLE; CLINICAL TRIAL; CONCENTRATION (PARAMETERS); EMERGENCY WARD; FEMALE; HUMAN; INHALATION ANESTHESIA; MALE; PRESCHOOL CHILD; PRIORITY JOURNAL; SCHOOL CHILD; SCORING SYSTEM; SEDATION; VOMITING;

ADJUVANTS, ANESTHESIA; ADMINISTRATION, INTRANASAL; ADOLESCENT; ANESTHETICS, INHALATION; CHI-SQUARE DISTRIBUTION; CHILD; CHILD, PRESCHOOL; CONSCIOUS SEDATION; EMERGENCY SERVICE, HOSPITAL; FEMALE; FENTANYL; HUMANS; INFANT; MALE; NITROUS OXIDE; PILOT PROJECTS; PROSPECTIVE STUDIES; STATISTICS, NONPARAMETRIC;

EID: 84855998081     PISSN: 10696563     EISSN: 15532712     Source Type: Journal    
DOI: 10.1111/j.1553-2712.2011.01241.x     Document Type: Article

References (30)

1. Krauss B, Green SM,. Procedural sedation and analgesia in children. Lancet. 2006; 367: 766-80. (Pubitemid 43326295)
2. Babl FE, Oakley E, Seaman C, Barnett P, Sharwood L,. High-concentration nitrous oxide for procedural sedation in children: adverse events and depth of sedation. Pediatrics. 2008; 121: e528-32.
3. Burton JH, Auble TE, Fuchs SM,. Effectiveness of 50% nitrous oxide/50% oxygen during laceration repair in children. Acad Emerg Med. 1998; 5: 1191-8.
4. Hennrikus WL, Simpson RB, Klingelberger CE, Reis M,. Self-administered nitrous oxide analgesia for pediatric fracture reductions. J Pediatr Orthoped. 1994; 14: 538-42. (Pubitemid 24191405)
5. Luhmann JD, Schootman M, Luhmann SJ, Kennedy RM,. A randomized comparison of nitrous oxide plus hematoma block versus ketamine plus midazolam for emergency department forearm fracture reduction in children. Pediatrics. 2006; 118: e1078-86. (Pubitemid 46393757)
6. Annequin D, Carbajal R, Chauvin P, Gall O, Tourniaire B, Murat I,. Fixed 50% nitrous oxide oxygen mixture for painful procedures: a French survey. Pediatrics. 2000; 105: E47.
7. Krauss B,. Continuous-flow nitrous oxide: searching for the ideal procedural anxiolytic for toddlers. Ann Emerg Med. 2001; 37: 61-2. (Pubitemid 32066343)
8. Krauss B, Green SM,. Sedation and analgesia for procedures in children. N Engl J Med. 2000; 342: 938-45. (Pubitemid 30177055)
9. Babl FE, Oakley E, Puspitadewi A, Sharwood LN,. Limited analgesic efficacy of nitrous oxide for painful procedures in children. Emerg Med J. 2008; 25: 717-21.
10. Borland M, Jacobs I, King B, O'Brien D,. A randomized controlled trial comparing intranasal fentanyl to intravenous morphine for managing acute pain in children in the emergency department. Ann Emerg Med. 2007; 49: 335-40.
11. Borland ML, Bergesio R, Pascoe EM, Turner S, Woodger S,. Intranasal fentanyl is an equivalent analgesic to oral morphine in paediatric burns patients for dressing changes: a randomised double blind crossover study. Burns. 2005; 31: 831-7. (Pubitemid 41394138)
12. Borland ML, Jacobs I, Geelhoed G,. Intranasal fentanyl reduces acute pain in children in the emergency department: a safety and efficacy study. Emerg Med. 2002; 14: 275-80.
13. Crellin D, Ling RX, Babl FE,. Does the standard intravenous solution of fentanyl (50μg/ml) administered intranasally have analgesic efficacy? Emerg Med Australas. 2010; 22: 62-7.
14. Finn M, Harris D,. Intranasal fentanyl for analgesia in the paediatric emergency department. Emerg Med J. 2010; 27: 300-1.
15. Babl FE,. Sedation Manual. 2nd ed. Children's Hospital, Melbourne. Available at:. Accessed Oct 7, 2011.
16. Babl F, Priestley S, Krieser D, et al., Development and implementation of an education and credentialing program to provide safe paediatric procedural sedation in emergency departments. Emerg Med Australas. 2006; 18: 489-97. (Pubitemid 44651697)
17. Babl FE, Krieser D, Belousoff J, Theophilos T,. Evaluation of a paediatric procedural sedation training and credentialing program: sustainability of change. Emerg Med J. 2010; 27: 577-81.
18. Borland M, Milsom S, Esson A,. Equivalency of two concentrations of fentanyl administered by the intranasal route for acute analgesia in children in a paediatric emergency department: a randomized controlled trial. Emerg Med Australas. 2011; 23: 202-8.
19. Malviya S, Voepel-Lewis T, Tait AR, Merkel S, Tremper K, Naughton N,. Depth of sedation in children undergoing computed tomography: validity and reliability of the University of Michigan Scale (UMSS). Br J Anaesth. 2002; 88: 241-5. (Pubitemid 34145002)
20. Bhatt M, Kennedy RM, Osmond MH, et al., Consensus-based recommendations for standardizing terminology and reporting adverse events for emergency department procedural sedation and analgesia in children. Ann Emerg Med. 2009; 53: 426-36.
21. Zier JL, Tarrango R, Liu M,. Level of sedation with nitrous oxide for paediatric medical procedures. Anesth Analg. 2010; 110: 1399-405.
22. Klein EJ, Diekema DS, Paris CA, Quan L, Cohen M, Seidel KD,. A randomized, clinical trial of oral midazolam plus placebo versus oral midazolam plus oral transmucosal fentanyl for sedation during laceration repair. Pediatrics. 2002; 109: 894-7. (Pubitemid 34493358)
23. Fisher A, Watling M, Smith A, Knight A,. Pharmacokinetic comparisons of three nasal fentanyl formulations; pectin, chitosan and chitosan-poloxamer 188. Int J Clin Pharmacol Ther. 2010; 48: 138-45.
24. Hoffman GM, Nowakowski R, Troshynski TJ, Berens RJ, Weisman SJ,. Risk reduction in pediatric procedural sedation by application of an American Academy of Pediatrics/American Society of Anesthesiologists process model. Pediatrics. 2002; 109: 236-43. (Pubitemid 34126863)
25. Green SM, Krauss B,. Pulmonary aspiration risk during ED procedural sedation: an examination of the role of fasting and sedation depth. Acad Emerg Med. 2002; 9: 35-42. (Pubitemid 34049225)
26. Green SM, Roback MG, Milner RM, Burton JH, Krauss B,. Fasting and emergency department procedural sedation and analgesia: a consensus-based clinical practise advisory. Ann Emerg Med. 2007; 49: 454-61. (Pubitemid 46413422)
27. Green SM,. Fasting is a consideration - not a necessity - for emergency department procedural sedation and analgesia. Ann Emerg Med. 2003; 42: 647-50. (Pubitemid 37329019)
28. Babl FE, Puspitadewi A, Barnett P, Oakley E, Spicer M,. Pre-procedural fasting state and adverse events in children receiving nitrous oxide for procedural sedation and analgesia. Paediatr Emerg Care. 2005; 21: 736-43. (Pubitemid 41689565)
29. Langston WT, Wathen JE, Roback MG, Bajaj L,. Effect of ondansetron on the incidence of vomiting associated with ketamine sedation in children: a double-blind, randomized, placebo-controlled trial. Ann Emerg Med. 2008; 52: 30-4.
30. Babl FE, Belousoff J, Theophilos T, Hopper S, Deasy C,. Paediatric procedural sedation based on nitrous oxide and ketamine: data from an Australian sedation registry. Emerg Med J. 2010; 27: 607-12.