A PROSPECTIVE ANALYSIS OF INTRAMUSCULAR MEPERIDINE, PROMETHAZINE, AND CHLORPROMAZINE IN PEDIATRIC EMERGENCY DEPARTMENT PATIENTS

被引：46
作者：
TERNDRUP, TE
DIRE, DJ
MADDEN, CM
DAVIS, H
CANTOR, RM
GAVULA, DP
机构：
[1] Departments of Critical Care and Emergency Medicine and Pediatrics, State University, New York Health Science Center at Syracuse, Syracuse
[2] Department of Emergency Medicine, Darnall Army Community Hospital, Fort Hood, TX
来源：
ANNALS OF EMERGENCY MEDICINE | 1991年 / 20卷 / 01期
关键词：
chlorpromazine; meperidine; promethazine;
D O I：
10.1016/S0196-0644(05)81114-X
中图分类号：
R4 [临床医学];
学科分类号：
1002 ; 100602 ;
摘要：
Study objective: To examine physiologic responses and efficacy of 2, 1, and 1 mg/kg IM meperidine, promethazine, and chlorpromazine (MPC), respectively, in children. Design: Prospective, unblinded trial. Setting: A university and community emergency department. Patients: Sixty-three hemodynamically and neurologically stable children. Intervention: Single dose of IM MPC. Measurements and main results: Serial respirations, heart rate, arterial systolic blood pressure, oxygen saturation, and Glasgow Coma Scale were measured at 30-minute intervals. Effectiveness was assessed by two independent observers using separate visual analog scales for cooperation and sedation. Times to sleep (27 +/- 24 minutes), sitting upright (103 +/- 87 minutes), ED discharge (4.7 +/- 2.4 hours), eating (11 +/- 7.9 hours), and normal behavior (19 +/- 15 hours) were acceptable. Minor, but statistically significant, changes in respiration rate (-1.9 +/- 0.4), heart rate (+4.5 +/- 1.8), oxygen saturation (-0.7 +/- 0.3%), and Glasgow Coma Scale (-2.5 +/- 0.6) occurred for 120 minutes after MPC. No serious complications or resuscitation were required. Mean visual analog scale scores were 5.0/10.4 or more in 71% of cases, with interobserver agreement very good (cooperation, r = .79; effectiveness, r = .80). Twenty-nine percent of children were judged insufficiently sedated. Conclusion: IM MPC is a safe and generally effective agent for ED procedures in selected children.
引用
收藏
页码：31 / 35
页数：5
相关论文
共 34 条
  • [1] Smith, Rowe, Vlad, Sedation of children for cardiac catheterization with an ataractic mixture, Can Anaesth Soc J, 5, pp. 35-40, (1958)
  • [2] Buchmann, Premedication in children, Acta Anaesth Scand, 9, pp. 139-144, (1965)
  • [3] Rosen, Rosenstein, Premedication as an adjunct in the dental management of patients with severe cerebral palsy, J Oral Therap Pharmacol, 3, pp. 194-202, (1966)
  • [4] Israel, Hohn, Black, Et al., Evaluation of sedation during cardiac catheterization of children, J Pediatrics, 70, pp. 407-412, (1967)
  • [5] Fixler, Carrell, Browne, Et al., Oxygen consumption in infants and children during cardiac catheterization under different sedation regimens, Circulation, 50, pp. 788-794, (1974)
  • [6] Myers, Shoaf, The intramuscular use of a combination of meperidine, promethazine and chlorpromazine for sedation of the child dental patient, J Dent Child, 44, pp. 453-456, (1977)
  • [7] Anderson, Osbom, Efficacy of simple sedation for pediatric computed tomography, Radiology, 124, pp. 739-740, (1977)
  • [8] Graham, Klish, Ferry, Et al., Value of fiberoptic gastrointestinal endoscopy in infants and children, South Med J, 71, pp. 558-560, (1978)
  • [9] Burckart, White, Siegle, Et al., Rectal thiopental versus an intramuscular cocktail for sedating children before computerized tomography, Am J Hosp Pharm, 37, pp. 222-224, (1980)
  • [10] Ahn, Andersen, Thomsen, Et al., Preanaesthetic medication with rectal diazepam in children, Acta Anaesth Scand, 25, pp. 158-160, (1981)
1234