PEDIATRICS Vol. 86 No. 3 September 1990, pp. 463-467
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Midazolam-Fentanyl Intravenous Sedation in Children: Case Report of Respiratory Arrest

Myron Yaster MD1, David G. Nichols MD1, Jayant K. Deshpande MD1, and Randall C. Wetzel MD1

1 Dept of Anesthesiology/Critical Care Medicine and Pediatrics, The Johns Hopkins Medical Institutions, Baltimore, MD

Children undergoing diagnostic or therapeutic procedures are often frightened and uncooperative. This fear may be exacerbated by parental anxiety, by separation from parents, and by pain or the anticipation of pain from the procedure itself. To achieve satisfactory sedation and analgesia, various drugs administered alone and in combination have been recommended using either an oral,1 intramuscular,2-5 intravenous,6-8 or a rectal9,10 route of administration. Although each has some purported advantage, none of the drugs or techniques that are currently available are absolutely safe or completely reliable.11-14 Because of this concern for safety and efficacy, many children experiencing procedure-related pain are often inadequately treated with analgesics and are immobilized primarily by physical restraint.

Submitted on July 3, 1989
Accepted on October 6, 1989




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