Experiencia en sedoanalgesia vinculada a procedimientos en un departamento de emergencia pediátrica

Mariana Más Gómez; Paloma Amarillo Martínez; María Soledad Tórtora; Patricia Dall’Orso; Javier Prego Petit

doi:10.29193/RMU.36.4.3

Authors

Mariana Más Gómez Universidad de la República, Facultad de Medicina, Centro Hospitalario Pereira Rossell, Hospital Pediátrico, Departamento de Emergencia Pediátrica, Prof. Adj. Emergencia Pediátrica
Paloma Amarillo Martínez Universidad de la República, Facultad de Medicina, Centro Hospitalario Pereira Rossell, Hospital Pediátrico, Departamento de Emergencia Pediátrica, Asist. Emergencia Pediátrica
María Soledad Tórtora Universidad de la República, Facultad de Medicina, Centro Hospitalario Pereira Rossell, Hospital Pediátrico, Departamento de Emergencia Pediátrica, Prof. Adj. Emergencia Pediátrica
Patricia Dall’Orso Universidad de la República, Facultad de Medicina, Centro Hospitalario Pereira Rossell, Hospital Pediátrico, Departamento de Emergencia Pediátrica, Prof. Agda. Emergencia Pediátrica
Javier Prego Petit Universidad de la República, Facultad de Medicina, Centro Hospitalario Pereira Rossell, Hospital Pediátrico, Departamento de Emergencia Pediátrica, Prof. Emergencia Pediátrica

DOI:

https://doi.org/10.29193/RMU.36.4.3

Keywords:

PAIN MANAGEMENT, ANALGESIA, HOSPITAL EMERGENCY SERVICE, CHILD, ANALGESICS, KETAMINE, FENTANYL

Abstract

Introduction: painful procedures are gradually increasing frequency in pediatrics emergency units. Controlling pain and mitigating fear and anxiety are of the essence when assisting pediatric patients and one of the priorities of emergency doctors.
Objective: to describe using sedoanalgesia with ketamine and fentanyl as the only drug or associated with other drugs during painful procedures, at the Pediatrics Emergency Unit, of the Pereira Rossell Hospital Center.
Method: descriptive, retrospective study from January 2011 to July 2016. Population: all patients who received sedoanalgesia with ketamine and fentanyl (as the only drug or associated with other drugs) during painful procedures at the Pediatrics Emergency Unit, of the Pereira Rossell Hospital Center. Database: medical records. Effectiveness was measured by success of the procedure and safety in terms of adverse effects in connection with it.
Results: N=352 children younger than 15 years old. 96 received ketamine and 256 received fentanyl. Average age was 7 years old and 245 of them were boys. Average dose of ketamine was 1 mg/kg, average dose of fentanyl was 1 g/kg. Main indications for sedoanalgesia included: orthopaedic procedures (264), thoracentesis (62). Procedures were successful in 352 patients. 100% of cases involved cardiovascular monitoring and blood oxygen saturation meter. Adverse effects: 6 (no advanced life support manoeuvres required). No patient changed final destination.
Conclusions: the use of sedoanalgesia was effective and safe, when applied by emergengy pediatricians qualified in the handling of drugs and advanced life support. Monitoring during and after procedure is required to determine and solve complications at an early stage.

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