What is the role of induction/hypnotic agents in pediatric sedation?

Updated: May 08, 2018
  • Author: Wan-Tsu Wendy Chang, MD; Chief Editor: Ted Rosenkrantz, MD  more...
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Answer

Induction/hypnotic agents that provide rapid loss of consciousness include nitrous oxide, ketamine, and propofol. Ketamine also provides analgesia and amnestic effects. Etomidate, an ultrashort-acting sedative, is used frequently in adults for rapid sequence induction. It appears to have neuroprotective properties and minimal cardiovascular effects. Although some studies suggest that etomidate may be efficacious in pediatric patients, the utility of this agent in this population has not been fully established.

A small study compared the effects of etomidate plus fentanyl with those of ketamine plus midazolam during orthopedic reductions in a pediatric ED. [15] The results indicated that the incidence of adverse reactions to ketamine, including emergence phenomenon, may be lower than was previously thought.


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