scholarly journals DEX Marks the Spot: Finding the Optimal Sedation Regimen for Pediatric Patients Undergoing Sedated Transthoracic Echocardiography

2020 ◽  
Vol 34 (6) ◽  
pp. 1556-1557
Author(s):  
Genevieve E. Staudt ◽  
Susan S. Eagle
Keyword(s):  
Transthoracic Echocardiography ◽  
Pediatric Patients ◽  
Sedation Regimen

A Retrospective Study of 248 Pediatric Oral Sedations Utilizing the Combination of Meperidine and Hydroxyzine for Dental Treatment

2015 ◽  
Vol 39 (5) ◽  
pp. 481-487 ◽  
Author(s):  
M Lenahan ◽  
M Wells ◽  
M Scarbecz
Keyword(s):  
Pediatric Patients ◽  
Dental Treatment ◽  
Major Complication ◽  
Operator Experience ◽  
Pediatric Dentist ◽  
Effectiveness Factors ◽  
Oral Sedation ◽  
Potential Factors ◽  
University Setting ◽  
Sedation Regimen

Oral sedation for pre-cooperative and anxious pediatric patients is an important tool for the pediatric dentist. Few studies have examined the sedation regimen of meperidine and hydroxyzine. Objectives: The primary goal of this study was to evaluate the overall safety and effectiveness of the meperidine/hydroxyzine drug combination. Secondary goals included detecting potential factors that alter sedation effectiveness. Study Design: Two hundred and forty eight electronic health records of pediatric patients (131 females, 117 males) who received meperidine/hydroxyzine sedations in a university setting were evaluated. Pediatric dental residents rated each case according to the Frankl behavioral scale and for effectiveness. Numerous factors were analyzed to evaluate their significance on overall effectiveness. Factors examined included age at time of treatment, gender, ASA status, Frankl score at various points during treatment, sextant of treatment, operator experience, dosage, use of nitrous oxide, and any complications encountered during treatment, both major and minor. Results: Over 81% of sedations were considered effective or very effective. Statistically significant findings included age of patient, pre-sedation behavior, and willingness to take the medication. Less than 5% of sedations were aborted due to behavior. Only one major complication was found, which was not related to the sedation. Conclusions: Meperidine combined with hydroxyzine is a safe and effective sedation regimen for uncooperative or pre-cooperative children during dental treatment.

Subcutaneous dexmedetomidine infusions to treat or prevent drug withdrawal in infants and children

2018 ◽  
Vol 4 (4) ◽  
pp. 187 ◽  
Author(s):  
Joseph D. Tobias, MD
Keyword(s):  
Pediatric Patients ◽  
Drug Withdrawal ◽  
Subcutaneous Administration ◽  
Pediatric Intensive Care ◽  
Venous Access ◽  
Subcutaneous Infusion ◽  
Peripheral Venous Access ◽  
Prolonged Sedation ◽  
Dexmedetomidine Infusion ◽  
Sedation Regimen

This retrospective study reports a cohort of pediatric patients in whom subcutaneous dexmedetomidine was used to treat or prevent drug withdrawal following prolonged sedation in the Pediatric Intensive Care Unit setting. There were seven patients ranging in age from 6 months to 3.75 years and in weight from 4.8 to 17.7 kg. The dexmedetomidine infusion before switching to subcutaneous administration varied from 0.8 to 1.4 μg/kg/h. Four of the patients had received dexmedetomidine in conjunction with an opioid as part of a sedation regimen during mechanical ventilation. In these four patients, the duration of the intravenous dexmedetomidine infusion varied from 4 to 10 days. In the three other patients, an intravenous dexmedetomidine infusion was used to treat withdrawal following the prolonged use of an opioid and/or a benzodiazepine. In these three patients, the duration of the intravenous dexmedetomidine varied from 3 to 5 days. Following the switch to subcutaneous dexmedetomidine, the infusion was gradually decreased by 0.1 μg/kg/h every 12 h. Subcutaneous access was maintained, and subcutaneous dexmedetomidine was administered for 4 to 7 days. No problems with the subcutaneous access were noted during treatment. No patient exhibited behavior suggestive of withdrawal during the use of subcutaneous dexmedetomidine. The maximum modified Finnegan score in the seven patients varied from 3 to 7. Our preliminary experience suggests that dexmedetomidine can be administered by subcutaneous infusion without difficulty or alteration of its efficacy. This approach allows the administration of dexmedetomidine when peripheral venous access becomes problematic and may facilitate the removal of central venous catheters in patients recovering from critical illnesses. It also offers the possibility of using dexmedetomidine in settings where peripheral venous access is not available such as home palliative care.

scholarly journals Comparative study of intranasal dexmedetomidine v/s midazolam for sedation of pediatric patients during transthoracic echocardiography

2021 ◽  
Vol 24 (2) ◽  
pp. 224
Author(s):  
Jigisha Pujara ◽  
Suvendu Panda ◽  
Ankit Chauhan ◽  
Abhishek Varma ◽  
Rajesh venuthurupalli ◽  
...  
Keyword(s):  
Comparative Study ◽  
Transthoracic Echocardiography ◽  
Pediatric Patients

Audiology Service Models in a Family Physician Practice Setting

2010 ◽  
Vol 6 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Sridhar Krishnamurti
Keyword(s):  
Pediatric Patients ◽  
Practice Patterns ◽  
Healthcare Delivery ◽  
Direct Consequence ◽  
Direct Access ◽  
Practice Setting ◽  
Pediatric Populations ◽  
Family Practice Physicians ◽  
Primary Focus ◽  
Balance Problems

This article illustrates the potential of placing audiology services in a family physician’s practice setting to increase referrals of geriatric and pediatric patients to audiologists. The primary focus of family practice physicians is the diagnosis/intervention of critical systemic disorders (e.g., cardiovascular disease, diabetes, cancer). Hence concurrent hearing/balance disorders are likely to be overshadowed in such patients. If audiologists get referrals from these physicians and have direct access to diagnose and manage concurrent hearing/balance problems in these patients, successful audiology practice patterns will emerge, and there will be increased visibility and profitability of audiological services. As a direct consequence, audiological services will move into the mainstream of healthcare delivery, and the profession of audiology will move further towards its goals of early detection and intervention for hearing and balance problems in geriatric and pediatric populations.

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