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Pharmacology and Clinical Application of Sedatives, Analgesics, and Adjuncts

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Pediatric Sedation Outside of the Operating Room

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Abstract

The overall objective in sedation outside the operating room is to provide effective and safe sedation.

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References

  1. American Academy of Pediatrics, American Academy of Pediatric Dentistry, Coté CJ, Wilson S, Work Group on Sedation. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update. Pediatrics. 2006;118(6):2587–602.

    PubMed  Google Scholar 

  2. American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by nonanesthesiologists. Anesthesia. 2002;96:1004–17.

    Google Scholar 

  3. Dial S, Silver P, Bock K, Sagy M. Pediatric sedation for procedures titrated to a desired degree of immobility results in unpredictable depth of sedation. Pediatr Emerg Care. 2001;17(6):414–20.

    PubMed  CAS  Google Scholar 

  4. Maxwell LG, Yaster M. The myth of conscious ­sedation. Arch Pediatr Adolesc Med. 1996;150(7):665–7.

    PubMed  CAS  Google Scholar 

  5. American Academy of Pediatrics, Committee on Drugs. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures. Pediatrics. 1992;89(6 Pt 1):1110–5.

    Google Scholar 

  6. Yaster M, Nichols DG, Deshpande JK, Wetzel RC. Midazolam-fentanyl intravenous sedation in children: case report of respiratory arrest. Pediatrics. 1990;86(3):463–7.

    PubMed  CAS  Google Scholar 

  7. Dallimore D, Herd DW, Short T, Anderson BJ. Dosing ketamine for pediatric procedural sedation in the emergency department. Pediatr Emerg Care. 2008;24(8):529–33.

    PubMed  Google Scholar 

  8. Coté CJ, Karl HW, Notterman DA, Weinberg JA, McCloskey C. Adverse sedation events in pediatrics: analysis of medications used for sedation. Pediatrics. 2000;106(4):633–44.

    PubMed  Google Scholar 

  9. Lopez JM, Valeron M, Perez O, Consuegra E, Urquia L, Moron A, et al. Safety and effectiveness of the sedoanalgesia with fentanyl and propofol. Experience in a pediatric intensive medicine unit. Med Intensiva. 2007;31(8):417–22.

    PubMed  CAS  Google Scholar 

  10. Oraishi SA, Girdharry TD, Xu SG, Orkin FK. Prolonged retrograde amnesia following sedation with propofol in a 12-year old boy. Paediatr Anaesth. 2007;17(4):375–9.

    Google Scholar 

  11. Veselis RA, Reinsel RA, Feshchenko VA, Wronski M. The comparative amnestic effects of midazolam, propofol, thiopental and fentanyl at equisedative concentrations. Anesthesiology. 1997;87(4):749–64.

    PubMed  CAS  Google Scholar 

  12. Wagner BK, O’Hara DA, Hammond JS. Drugs for amnesia in the ICU. Am J Crit Care. 1997;6(3):192–201.

    PubMed  CAS  Google Scholar 

  13. Koirala B, Pandev RK, Saksen AK, Kumar R, Sharma S. A comparative evaluation of newer sedatives in conscious sedation. J Clin Pediatr Dent. 2006;30(4):273–6.

    PubMed  Google Scholar 

  14. Heinrich M, Wetzstein V, Muensterer OJ, Till H. Conscious sedation: off-label use of rectal S(+)-ketamine and midazolam for wound dressing changes in paediatric heat injuries. Eur J Pediatr Surg. 2004;14(4):235–9.

    PubMed  CAS  Google Scholar 

  15. Buffett-Jerrott SE, Stewart SH, Finley GA, Loughlan HL. Effects of benzodiazepines on explicit memory in a paediatric surgery setting. Psychopharmacology (Berl). 2003;168(4):377–86.

    CAS  Google Scholar 

  16. Pringle B, Dahlquist LM, Eskenazi A. Memory in pediatric patients undergoing conscious sedation for aversive medical procedures. Health Psychol. 2003;22(3):263–9.

    PubMed  Google Scholar 

  17. Henry DW, Burwinkle JW, Klutman NE. Determination of sedative and amnestic doses of lorazepam in children. Clin Pharm. 1991;10(8):625–9.

    PubMed  CAS  Google Scholar 

  18. Kennedy RM, Porter FL, Miller JP, Jaffe DM. Comparison of fentanyl/midazolam with ketamine/ midazolam for pediatric orthopedic emergencies. Pediatrics. 1998;102(4 Pt 1):956–63.

    PubMed  CAS  Google Scholar 

  19. http://www.fda.gov/ScienceResearch/SpecialTopics/RunningClinicalTrials/GuidancesInformationSheetsandNotices/ucm116355.htm. Accessed 10 Jan 2010.

  20. American Academy of Pediatrics, Committee on Drugs. Alternative routes of drug administration – advantages and disadvantages (subject review). Pediatrics. 1997;100(1):143–52.

    Google Scholar 

  21. Mellon RD, Simone AF, Rappaport BA. Use of ­anesthetic agents in neonates and young children. Anesth Analg. 2007;104(3):509–20.

    PubMed  CAS  Google Scholar 

Alfentanil

  1. Brenchley J, Ramlakhan S. Intranasal alfentanil for acute pain in children. Emerg Med J. 2006;23(6):488.

    PubMed  CAS  Google Scholar 

  2. Schwagmeier R, Boerger N, Meissner W, Striebel HW. Pharmacokinetics of intranasal alfentanil. J Clin Anesth. 1995;7(2):109–13.

    PubMed  CAS  Google Scholar 

  3. http://www.akorn.com/documents/catalog/package_inserts/17478-067-05.pdf. Accessed 26 Jan 2010.

Pharmacokinetics

  1. Baririan N, Van Obbergh L, Desager JP, Verbeeck RK, Wallemacq P, Starkel P, et al. Alfentanil-induced miosis as a surrogate measure of alfentanil pharmacokinetics in patients with mild and moderate liver cirrhosis. Clin Pharmacokinet. 2007;46(3):261–70.

    PubMed  CAS  Google Scholar 

  2. Fiset P, Mathers L, Engstrom R, Fitzgerald D, Brand SC, Hsu F, et al. Pharmacokinetics of computer-­controlled alfentanil administration in children ­undergoing cardiac surgery. Anesthesiology. 1995;83(5):944–55.

    PubMed  CAS  Google Scholar 

  3. den Hollander JM, Hennis PJ, Burm AG, Vletter AA, Bovill JG. Pharmacokinetics of alfentanil before and after cardiopulmonary bypass in pediatric patients undergoing cardiac surgery: part I. J Cardiothorac Vasc Anesth. 1992;6(3):308–12.

    Google Scholar 

  4. Marlow N, Weindling AM, Van Peer A, Heykants J. Alfentanil pharmacokinetics in preterm infants. Arch Dis Child. 1990;65(4 Spec No):349–51.

    PubMed  CAS  Google Scholar 

  5. Davis PJ, Stiller RL, Cook DR, Brandom BW, Davis JE, Scierka AM. Effects of cholestatic hepatic disease and chronic renal failure on alfentanil pharmacokinetics in children. Anesth Analg. 1989;68(5):579–83.

    PubMed  CAS  Google Scholar 

  6. Davis PJ, Killian A, Stiller RL, Cook DR, Guthrie RD, Scierka AM. Pharmacokinetics of alfentanil in newborn premature infants and older children. Dev Pharmacol Ther. 1989;13(1):21–7.

    PubMed  CAS  Google Scholar 

  7. den Hollander JM, Hennis PJ, Burm AG, Bovill JG. Alfentanil in infants and children with congenital heart defects. J Cardiothorac Anesth. 1988;2(1):12–7.

    Google Scholar 

  8. Roure P, Jean N, Leclerc AC, Cabanel N, Levron JC, Duvaldestin P. Pharmacokinetics of alfentanil in children undergoing surgery. Br J Anaesth. 1987;59(11):1437–40.

    PubMed  CAS  Google Scholar 

  9. Goresky GV, Koren G, Sabourin MA, Sale JP, Strunin L. The pharmacokinetics of alfentanil in children. Anesthesiology. 1987;67(5):654–9.

    PubMed  CAS  Google Scholar 

  10. Meistelman C, Saint-Maurice C, Lepaul M, Levron JC, Loose JP, Mac Gee K. A comparison of alfentanil pharmacokinetics in children and adults. Anesthesiology. 1987;66(1):13–6.

    PubMed  CAS  Google Scholar 

  11. Van Peer A, Levron JC, Noorduin H, Heykants J. Overview of the clinical pharmacokinetics of ­alfentanil. Acta Anaesthesiol Belg. 1984;35(Suppl):261–3.

    PubMed  Google Scholar 

Clinical Application

  1. Gutstein HB, Akil H. Opioid analgesics. In: Brunton LL, Lzo JS, Parker KL, editors. Goodman and Gilman’s the pharmacological basis of therapeutics. 11th ed. New York: McGraw-Hill; 2006. p. 547–90.

    Google Scholar 

Chloral Hydrate

  1. Lovinger DM, Zimmerman SA, Levitin M, et al. Trichloroethanol potentiates synaptic transmission mediated by γ-aminobutyric acid receptors in hippocampal neurons. J Pharmacol Exp Ther. 1993;264:1097–103.

    PubMed  CAS  Google Scholar 

  2. Treluyer JM, Andre C, Carp PF, Chalumeau M, Tonnelier S, Cuq C, et al. Sedation in children undergoing CT scan or MRI: effect of time-course and tolerance of rectal chloral hydrate. Fundam Clin Pharmacol. 2004;18(3):347–50.

    PubMed  CAS  Google Scholar 

  3. Sakaguchi M, Inouye S. Anaphylaxis to gelatin-containing rectal suppositories. J Allergy Clin Immunol. 2001;108(6):1033–4.

    PubMed  CAS  Google Scholar 

  4. Dacher JN, Neuenschwander S, Monroc M, Vanier A, Eurin D, Le Dosseur P. Sedation with oral hydroxyzine and rectal chloral hydrate in pediatric MRI and CT (Article in French). J Radiol. 1996;77(12):1189–92. Discussion 1193–4.

    PubMed  CAS  Google Scholar 

  5. Moody Jr EH, Mourino AP, Campbell RL. The therapeutic effectiveness of nitrous oxide and chloral hydrate administered orally, rectally, and combined with hydroxyzine for pediatric dentistry. ASDC J Dent Child. 1986;53(6):425–9.

    PubMed  Google Scholar 

  6. Baselt RC. Disposition of toxic drugs and chemicals in man. 7th ed. Foster City, CA: Biomedical; 2004.

    Google Scholar 

Pharmacokinetics

  1. Mayers DJ, Hindmarsh KW, Sankaran K, Gorecki DK, Kasian GF. Chloral hydrate disposition following single-dose administration to critically ill neonates and children. Dev Pharmacol Ther. 1991;16(2):71–7.

    PubMed  CAS  Google Scholar 

  2. Reimche LD, Sankaran K, Hindmarsh KW, Kasian GF, Gorecki DK, Tan L. Chloral hydrate sedation in neonates and infants-clinical and pharmacologic considerations. Dev Pharmacol Ther. 1989;12(2):57–64.

    PubMed  CAS  Google Scholar 

Clinical Application

  1. Pershad J, Palmisano P, Nichols M. Chloral hydrate: the good and the bad. Pediatr Emerg Care. 1999;15(6):432–5.

    PubMed  CAS  Google Scholar 

  2. American Academy of Pediatrics, Committee on Drugs and Committee on Environmental Health. Use of chloral hydrate for sedation in children. Pediatrics. 1993;92(3):471–3.

    Google Scholar 

Dexmedetomidine

  1. http://www.precedex.com/wp-content/uploads/2010/02/Precedex_Full_PI.pdf. Accessed 11 Oct 2010.

Buccal

  1. Sakurai Y, Obata T, Odaka A, Terui K, Tamura M, Miyao H. Buccal administration of dexmedetomidine as a preanesthetic in children. J Anesth. 2010;24(1):49–53.

    PubMed  Google Scholar 

  2. Karaaslan D, Peker TT, Alaca A, Ozmen S, Kirdemir P, Yorgancigil H, et al. Comparison of buccal and intramuscular dexmedetomidine premedication for arthroscopic knee surgery. J Clin Anesth. 2006;18(8):589–93.

    PubMed  CAS  Google Scholar 

  3. Anttila M, Penttilä J, Helminen A, Vuorilehto L, Scheinin H. Bioavailability of dexmedetomidine after extravascular doses in healthy subjects. Br J Clin Pharmacol. 2003;56(6):691–3.

    PubMed  Google Scholar 

  4. Penttilä J, Helminen A, Anttila M, Hinkka S, Scheinin H. Cardiovascular and parasympathetic effects of dexmedetomidine in healthy subjects. Can J Physiol Pharmacol. 2004;82(5):359–62.

    PubMed  Google Scholar 

Intranasal

  1. Talon MD, Woodson LC, Sherwood ER, Aarsland A, McRae L, Benham T. Intranasal dexmedetomidine premedication is comparable with midazolam in burn children undergoing reconstructive surgery. J Burn Care Res. 2009;30(4):599–605.

    PubMed  Google Scholar 

  2. Yuen VM, Hui TW, Irwin MG, Yuen MK. A comparison of intranasal dexmedetomidine and oral midazolam for premedication in pediatric anesthesia: a double-blinded randomized controlled trial. Anesth Analg. 2008;106(6):1715–21.

    PubMed  CAS  Google Scholar 

  3. Yuen VM, Irwin MG, Hui TW, Yuen MK, Lee LH. A double-blind, crossover assessment of the sedative and analgesic effects of intranasal dexmedetomidine. Anesth Analg. 2007;105(2):374–80.

    PubMed  CAS  Google Scholar 

Pharmacokinetics and Pharmacodynamics

  1. Petroz GC, Sikich N, James M, van Dyk H, Shafer SL, Schily M, et al. A phase I, two-center study of the pharmacokinetics and pharmacodynamics of dexmedetomidine in children. Anesthesiology. 2006;105(6):1098–110.

    PubMed  CAS  Google Scholar 

  2. Díaz SM, Rodarte A, Foley J, Capparelli EV. Pharmacokinetics of dexmedetomidine in postsurgical pediatric intensive care unit patients: preliminary study. Pediatr Crit Care Med. 2007;8(5):419–24.

    PubMed  Google Scholar 

  3. Vilo S, Rautiainen P, Kaisti L, Aantaa R, Scheinin M, Manner T, et al. Pharmacokinetics of intravenous dexmedetomidine in children under 11 years of age. Br J Anaesth. 2008;100(5):697–700.

    PubMed  CAS  Google Scholar 

  4. Potts AL, Warman GR, Anderson BJ. Dexmedetomidine disposition in children: a population analysis. Paediatr Anesth. 2008;18(8):722–30.

    Google Scholar 

  5. Potts AL, Anderson BJ, Warman GR, Lerman J, Diaz SM, Vilo S. Dexmedetomidine pharmacokinetics in pediatric intensive care – a pooled analysis. Paediatr Anaesth. 2009;19(11):1119–29.

    PubMed  Google Scholar 

  6. Evers AS, Crowder CM, Balser JR. General anesthetics. In: Brunton LL, Laso JS, Parker KL, editors. Goodman and Gilman’s the pharmacological basis of therapeutics. 11th ed. New York: McGraw-Hill; 2006.

    Google Scholar 

Diazepam

  1. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=9112&type=pdf&name=41044928-dd1f-40bf-1fa6-709dff559124. Accessed 11 Oct 2010.

  2. Blumer JL. Clinical pharmacology of midazolam in infants and children. Clin Pharmacokinet. 1998;35(1):37–47.

    PubMed  CAS  Google Scholar 

Etomidate

  1. http://www.bedfordlabs.com/products/inserts/etomidate_pi.pdf. Accessed 11 Oct 2010.

  2. Sfez M, Le Mapihan Y, Levron JC, Gaillard JL, Rosemblatt JM, Le Moing JP. Comparison of the pharmacokinetics of etomidate in children and in adults. Ann Fr Anesth Rèanim. 1990;9(2):127–31.

    PubMed  CAS  Google Scholar 

Clinical Application

  1. Baxter AL, Mallory MD, Spandorfer PR, Sharma S, Freilich SH, Cravero J, et al. Etomidate versus pentobarbital for computed tomography sedations: report from the Pediatric Sedation Research Consortium. Pediatr Emerg Care. 2007;23(10):690–5.

    PubMed  Google Scholar 

  2. Di Liddo L, D’Angelo A, Nguyen B, Bailey B, Amre D, Stanciu C. Etomidate versus midazolam for procedural sedation in pediatric outpatients: a randomized controlled trial. Ann Emerg Med. 2006;48(4):433–40, 440e1.

    Google Scholar 

  3. Kienstra AJ, Ward MA, Sasan F, Hunter J, Morriss MC, Macias CG. Etomidate versus pentobarbital for sedation of children for head and neck CT imaging. Pediatr Emerg Care. 2004;20(8):499–506.

    PubMed  Google Scholar 

Fentanyl

  1. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=8638&type=pdf&name=a13ae145-5c5e-422b-d0a5-6cf34c1b8262. Accessed 7 Oct 2010.

Transdermal

  1. Zernikow B, Michel E, Anderson B. Transdermal fentanyl in childhood and adolescence: a comprehensive literature review. J Pain. 2007;8(3):187–207.

    PubMed  CAS  Google Scholar 

  2. Finkel JC, Finley A, Greco C, Weisman SJ, Zeltzer L. Transdermal fentanyl in the management of children with chronic severe pain: results from an international study. Cancer. 2005;104(12):2847–57.

    PubMed  CAS  Google Scholar 

  3. Noyes M, Irving H. The use of transdermal fentanyl in pediatric oncology palliative care. Am J Hosp Palliat Care. 2001;18(6):411–6.

    PubMed  CAS  Google Scholar 

  4. Hunt A, Goldman A, Devine T, Phillips M, FEN-GBR-14 Study Group. Transdermal fentanyl for pain relief in a paediatric palliative care population. Palliat Med. 2001;15(5):405–12.

    PubMed  CAS  Google Scholar 

  5. Mannerkoski MK, Heiskala HJ, Santavuori PR, Pouttu JA. Transdermal fentanyl therapy for pains in children with infantile neuronal ceroid lipofuscinosis. Eur J Paediatr Neurol. 2001;5(Suppl A):175–7.

    PubMed  Google Scholar 

  6. Collins JJ, Dunkel IJ, Gupta SK, Inturrisi CE, Lapin J, Palmer LN, et al. Transdermal fentanyl in children with cancer pain: feasibility, tolerability, and pharmacokinetic correlates. J Pediatr. 1999;134(3):319–23.

    PubMed  CAS  Google Scholar 

  7. Clotz MA, Nahata MC. Clinical uses of fentanyl, sufentanil, and alfentanil. Clin Pharm. 1991;10(8):581–93.

    PubMed  CAS  Google Scholar 

Intranasal

  1. Chung S, Lim R, Goldman RD. Intranasal fentanyl versus placebo for pain in children during catheterization for voiding cystourethrography. Pediatr Radiol. 2010;40(7):1236–40.

    PubMed  Google Scholar 

  2. Holdgate A, Cao A, Lo KM. The implementation of intranasal fentanyl for children in a mixed adult and pediatric emergency department reduces time to analgesic administration. Acad Emerg Med. 2010;17(2):214–7.

    PubMed  Google Scholar 

  3. Cole J, Shepherd M, Young P. Intranasal fentanyl in 1-3-year-olds: a prospective study of the effectiveness of intranasal fentanyl as acute analgesia. Emerg Med Australas. 2009;21(5):395–400.

    PubMed  Google Scholar 

  4. Herd D, Borland M. Intranasal fentanyl paediatric clinical practice guidelines. Emerg Med Australas. 2009;21(4):335.

    PubMed  Google Scholar 

  5. Borland ML, Clark LJ, Esson A. Comparative review of the clinical use of intranasal fentanyl versus morphine in a paediatric emergency department. Emerg Med Australas. 2008;20(6):515–20. Erratum in: Emerg Med Australas. 2009;21(3):246. (Dosage error in article text).

    Google Scholar 

  6. Voronov P, Tobin MJ, Billings K, Coté CJ, Iyer A, Suresh S. Postoperative pain relief in infants undergoing myringotomy and tube placement: comparison of a novel regional anesthetic block to intranasal fentanyl – a pilot analysis. Paediatr Anaesth. 2008;18(12):1196–201.

    PubMed  Google Scholar 

  7. Ali S, Klassen TP. Intranasal fentanyl and intravenous morphine did not differ for pain relief in children with closed long-bone fractures. Evid Based Med. 2007;12(6):176.

    PubMed  Google Scholar 

  8. Wolfe T. Intranasal fentanyl for acute pain: techniques to enhance efficacy. Ann Emerg Med. 2007;49(5):721–2.

    PubMed  Google Scholar 

  9. Borland M, Jacobs I, King B, O’Brien D. A randomized controlled trial comparing intranasal fentanyl to intravenous morphine for managing acute pain in children in the emergency department. Ann Emerg Med. 2007;49(3):335–40.

    PubMed  Google Scholar 

  10. Borland ML, Bergesio R, Pascoe EM, Turner S, Woodger S. Intranasal fentanyl is an equivalent analgesic to oral morphine in paediatric burns patients for dressing changes: a randomised double blind crossover study. Burns. 2005;31(7):831–7.

    PubMed  CAS  Google Scholar 

  11. Borland ML, Jacobs I, Geelhoed G. Intranasal fentanyl reduces acute pain in children in the emergency department: a safety and efficacy study. Emerg Med (Fremantle). 2002;14(3):275–80.

    Google Scholar 

  12. Manjushree R, Lahiri A, Ghosh BR, Laha A, Handa K. Intranasal fentanyl provides adequate postoperative analgesia in pediatric patients. Can J Anaesth. 2002;49(2):190–3.

    PubMed  Google Scholar 

  13. Finkel JC, Cohen IT, Hannallah RS, Patel KM, Kim MS, Hummer KA, et al. The effect of intranasal fentanyl on the emergence characteristics after sevoflurane anesthesia in children undergoing surgery for bilateral myringotomy tube placement. Anesth Analg. 2001;92(5):1164–8.

    PubMed  CAS  Google Scholar 

  14. Galinkin JL, Fazi LM, Cuy RM, Chiavacci RM, Kurth CD, Shah UK, et al. Use of intranasal fentanyl in children undergoing myringotomy and tube placement during halothane and sevoflurane anesthesia. Anesthesiology. 2000;93(6):1378–83.

    PubMed  CAS  Google Scholar 

Transmucosal

  1. Mahar PJ, Rana JA, Kennedy CS, Christopher NC. A randomized clinical trial of oral transmucosal ­fentanyl citrate versus intravenous morphine sulfate for initial control of pain in children with extremity injuries. Pediatr Emerg Care. 2007;23(8):544–8.

    PubMed  Google Scholar 

  2. Zernikow B, Michel E, Craig F, Anderson BJ. Pediatric palliative care: use of opioids for the management of pain. Paediatr Drugs. 2009;11(2):129–51.

    PubMed  Google Scholar 

  3. Robert R, Brack A, Blakeney P, Villarreal C, Rosenberg L, Thomas C, et al. A double-blind study of the analgesic efficacy of oral transmucosal fentanyl citrate and oral morphine in pediatric patients undergoing burn dressing change and tubbing. J Burn Care Rehabil. 2003;24(6):351–5.

    PubMed  Google Scholar 

  4. Howell TK, Smith S, Rushman SC, Walker RW, Radivan F. A comparison of oral transmucosal fentanyl and oral midazolam for premedication in children. Anaesthesia. 2002;57(8):798–805.

    PubMed  CAS  Google Scholar 

  5. Klein EJ, Diekema DS, Paris CA, Quan L, Cohen M, Seidel KD. A randomized, clinical trial of oral midazolam plus placebo versus oral midazolam plus oral transmucosal fentanyl for sedation ­during laceration repair. Pediatrics. 2002;109(5):894–7.

    PubMed  Google Scholar 

  6. Moore PA, Cuddy MA, Magera JA, Caputo AC, Chen AH, Wilkinson LA. Oral transmucosal fentanyl pretreatment for outpatient general anesthesia. Anesth Prog. 2000 Spring;47(2):29–34.

    PubMed  CAS  Google Scholar 

  7. Sharar SR, Carrougher GJ, Selzer K, O’Donnell F, Vavilala MS, Lee LA. A comparison of oral transmucosal fentanyl citrate and oral oxycodone for pediatric outpatient wound care. J Burn Care Rehabil. 2002;23(1):27–31.

    PubMed  CAS  Google Scholar 

  8. Howell TK, Smith S, Rushman S, Walker RW. A comparison of oral transmucosal fentanyl and oral midazolam for premedication in children. Paediatr Anaesth. 2000;10(6):697.

    PubMed  Google Scholar 

  9. Sharar SR, Bratton SL, Carrougher GJ, Edwards WT, Summer G, Levy FH, et al. A comparison of oral transmucosal fentanyl citrate and oral hydromorphone for inpatient pediatric burn wound care analgesia. J Burn Care Rehabil. 1998;19(6):516–21.

    PubMed  CAS  Google Scholar 

  10. Ginsberg B, Dear RB, Margolis JO, Dear GD, Ross AK. Oral transmucosal fentanyl citrate as an anaesthetic premedication when dosed to an opioid effect vs total opioid consumption. Paediatr Anaesth. 1998;8(5):413–8.

    PubMed  CAS  Google Scholar 

  11. Dsida RM, Wheeler M, Birmingham PK, Henthorn TK, Avram MJ, Enders-Klein C, et al. Premedication of pediatric tonsillectomy patients with oral transmucosal fentanyl citrate. Anesth Analg. 1998;86(1):66–70.

    PubMed  CAS  Google Scholar 

  12. Weisman SJ, Bernstein B, Schechter NL. Consequences of inadequate analgesia during painful procedures in children. Arch Pediatr Adolesc Med. 1998;152(2):147–9.

    PubMed  CAS  Google Scholar 

  13. Malviya S, Voepel-Lewis T, Huntington J, Siewert M, Green W. Effects of anesthetic technique on side effects associated with fentanyl Oralet premedication. J Clin Anesth. 1997;9(5):374–8.

    PubMed  CAS  Google Scholar 

  14. Epstein RH, Mendel HG, Witkowski TA, Waters R, Guarniari KM, Marr AT, et al. The safety and efficacy of oral transmucosal fentanyl citrate for ­preoperative sedation in young children. Anesth Analg. 1996;83(6):1200–5.

    PubMed  CAS  Google Scholar 

  15. Schutzman SA, Liebelt E, Wisk M, Burg J. Comparison of oral transmucosal fentanyl citrate and intramuscular meperidine, promethazine, and chlorpromazine for conscious sedation of children undergoing laceration repair. Ann Emerg Med. 1996;28(4):385–90.

    PubMed  CAS  Google Scholar 

  16. Brenn BR. Side effects with use of oral transmucosal fentanyl. Pediatrics. 1995;96(3 Pt 1):544.

    PubMed  CAS  Google Scholar 

  17. Schechter NL, Weisman SJ, Rosenblum M, Bernstein B, Conard PL. The use of oral transmucosal fentanyl citrate for painful procedures in children. Pediatrics. 1995;95(3):335–9.

    PubMed  CAS  Google Scholar 

  18. Friesen RH, Carpenter E, Madigan CK, Lockhart CH. Oral transmucosal fentanyl citrate for preanaesthetic medication of paediatric cardiac surgery patients. Paediatr Anaesth. 1995;5(1):29–33.

    PubMed  CAS  Google Scholar 

  19. Schutzman SA, Burg J, Liebelt E, Strafford M, Schechter N, Wisk M, et al. Oral transmucosal fentanyl citrate for premedication of children undergoing laceration repair. Ann Emerg Med. 1994;24(6):1059–64.

    PubMed  CAS  Google Scholar 

  20. Friesen RH, Lockhart CH. Oral transmucosal fentanyl citrate for preanesthetic medication of pediatric day surgery patients with and without droperidol as a prophylactic anti-emetic. Anesthesiology. 1992;76(1):46–51.

    PubMed  CAS  Google Scholar 

  21. Lind GH, Marcus MA, Mears SL, Ashburn MA, Peterson BJ, Bernhisel KT, et al. Oral transmucosal fentanyl citrate for analgesia and sedation in the emergency department. Ann Emerg Med. 1991;20(10):1117–20.

    PubMed  CAS  Google Scholar 

  22. Goldstein-Dresner MC, Davis PJ, Kretchman E, Siewers RD, Certo N, Cook DR. Double-blind comparison of oral transmucosal fentanyl citrate with oral meperidine, diazepam, and atropine as preanesthetic medication in children with congenital heart disease. Anesthesiology. 1991;74(1):28–33.

    PubMed  CAS  Google Scholar 

  23. Ashburn MA, Streisand JB, Tarver SD, Mears SL, Mulder SM, Floet Wilms AW, et al. Oral ­transmucosal fentanyl citrate for premedication in paediatric outpatients. Can J Anaesth. 1990;37(8):857–66.

    PubMed  CAS  Google Scholar 

  24. Stanley TH, Leiman BC, Rawal N, Marcus MA, van den Nieuwenhuyzen M, Walford A, et al. The effects of oral transmucosal fentanyl citrate premedication on preoperative behavioral responses and gastric volume and acidity in children. Anesth Analg. 1989;69(3):328–35.

    PubMed  CAS  Google Scholar 

  25. Feld LH, Champeau MW, van Steennis CA, Scott JC. Preanesthetic medication in children: a comparison of oral transmucosal fentanyl citrate versus placebo. Anesthesiology. 1989;71(3):374–7.

    PubMed  CAS  Google Scholar 

  26. Streisand JB, Stanley TH, Hague B, van Vreeswijk H, Ho GH, Pace NL. Oral transmucosal fentanyl citrate premedication in children. Anesth Analg. 1989;69(1):28–34.

    PubMed  CAS  Google Scholar 

  27. Nelson PS, Streisand JB, Mulder SM, Pace NL, Stanley TH. Comparison of oral transmucosal fentanyl citrate and an oral solution of meperidine, diazepam, and atropine for premedication in children. Anesthe­siology. 1989;70(4):616–21.

    PubMed  CAS  Google Scholar 

Pharmacokinetics

  1. Katz R, Kelly HW. Pharmacokinetics of continuous infusions of fentanyl in critically ill children. Crit Care Med. 1993;21(7):995–1000.

    PubMed  CAS  Google Scholar 

  2. Paut O, Camboulives J, Viard L, Lemoing JP, Levron JC. Pharmacokinetics of transdermal fentanyl in the peri-operative period in young children. Anaesthesia. 2000;55(12):1202–7.

    PubMed  CAS  Google Scholar 

  3. Wheeler M, Birmingham PK, Lugo RA, Heffner CL, Coté CJ. The pharmacokinetics of the intravenous formulation of fentanyl citrate administered orally in children undergoing general anesthesia. Anesth Analg. 2004;99(5):1347–51.

    PubMed  CAS  Google Scholar 

Fospropofol

  1. Moore GD, Walker AM, MacLaren R. Fospropofol: a new sedative-hypnotic agent for monitored anesthesia care. Ann Pharmacother. 2009;43(11):1802–8.

    PubMed  CAS  Google Scholar 

  2. Garnock-Jones KP, Scott LJ. Fospropofol. Drugs. 2010;70(4):469–77.

    PubMed  CAS  Google Scholar 

  3. http://www.eisai.com/package_inserts/Lusedra_PI.pdf. Accessed 14 Feb 2011.

Ketamine

  1. http://www.bedfordlabs.com/BedfordLabsWeb/products/inserts/KTP06.pdf. Accessed 5 Feb 2010.

Pharmacokinetics

  1. Herd D, Anderson BJ. Ketamine disposition in children presenting for procedural sedation and analgesia in a children’s emergency department. Paediatr Anaesth. 2007;17(7):622–9.

    PubMed  Google Scholar 

  2. Maliknovsky JM, Servin F, Cozian A, Lepage JY, Pinaud M. Ketamine and norketamine plasma concentrations after i.v., nasal and rectal administration in children. Br J Anaesth. 1996;77(2):203–7.

    Google Scholar 

  3. Pedraz JL, Calvo MB, Lanao JM, Muriel C, Santos Lamas J, Domínguez-Gil A. Pharmacokinetics of rectal ketamine in children. Br J Anaesth. 1989;63(6):671–4.

    PubMed  CAS  Google Scholar 

  4. Grant IS, Nimmo WS, McNicol LR, Clements JA. Ketamine disposition in children and adults. Br J Anaesth. 1983;55(11):1107–11.

    PubMed  CAS  Google Scholar 

  5. Idvall J, Holassek J, Stenberg P. Rectal administration for induction of anesthesia in children. Anesthesia. 1983;38(1):60–4.

    CAS  Google Scholar 

Clinical Application

  1. Sinner B, Graf BM. Ketamine. Handb Exp Pharmacol. 2008(182):313–33.

    Google Scholar 

  2. Roelofse JA. The evolution of ketamine applications in children. Paediatr Anaesth. 2010;20(3):240–5.

    PubMed  Google Scholar 

Lorazepam

  1. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=18387&type=pdf&name=415672b5-bab8-437c-9ee4-9c729208eda3. Accessed 11 Oct 2010.

Pharmacokinetics

  1. Muchohi SN, Obiero K, Newton CR, Ogutu BR, Edwards G, Kokwaro GO. Pharmacokinetics and clinical efficacy of lorazepam in children with severe malaria and convulsions. Br J Clin Pharmacol. 2008;65(1):12–21.

    PubMed  CAS  Google Scholar 

  2. Relling MV, Mulhern RK, Dodge RK, Johnson D, Pieper JA, Rivera GK, et al. Lorazepam pharmacodynamics and pharmacokinetics in children. J Pediatr. 1989;114(4 Pt 1):641–6.

    PubMed  CAS  Google Scholar 

Meperidine

  1. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=17968&type=pdf&name=0084d5bc-17d5-4c58-a791-7ab3bb4590b7. Accessed 10 Oct 2010.

Pharmacokinetics

  1. Hamunen K, Maunuksela EL, Seppälä T, Olkkola KT. Pharmacokinetics of i.v. and rectal pethidine in children undergoing ophthalmic surgery. Br J Anaesth. 1993;71(6):823–6.

    PubMed  CAS  Google Scholar 

Methohexital

  1. Evers AS, Crowder CM, Balser JR. General Anesthetics. In: Brunton LL, Lzo JS, Parker KL, editors. Goodman and Gilman’s The Pharmacological Basis of Therapeutics. 11th ed. New York: McGraw-Hill; 2006. p. 341–68.

    Google Scholar 

  2. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=10311&type=pdf&name=eccd8340-ead3-4363-8902-0c19d33aa2ac. Accessed 10 Oct 2010.

  3. Forbes RB, Murray DJ, Dillman JB, Dull DL. Pharmacokinetics of two percent rectal methohexitone in children. Can J Anaesth. 1989;36(2):160–4.

    PubMed  CAS  Google Scholar 

  4. Kestin IG, McIlvaine WB, Lockhart CH, Kestin KJ, Jones MA. Rectal methohexital for induction of anesthesia in children with and without rectal aspiration after sleep: a pharmacokinetic and pharmacodynamic study. Anesth Analg. 1988;67(11):1102–4.

    PubMed  CAS  Google Scholar 

  5. Björkman S, Gabrielsson J, Quaynor H, Corbey M. Pharmacokinetics of i.v. and rectal methohexitone in children. Br J Anaesth. 1987;59(12):1541–7.

    PubMed  Google Scholar 

  6. Quaynor H, Corbey M, Björkman S. Rectal induction of anaesthesia in children with methohexitone. Patient acceptability and clinical pharmacokinetics. Br J Anaesth. 1985;57(6):573–7.

    PubMed  CAS  Google Scholar 

  7. Kraus G, Frank S, Knoll R, Prestele H. Pharmacokinetic studies following intravenous, intramuscular and rectal administration of methohexital in children. Anaesthesist. 1984;33(6):266–71.

    PubMed  CAS  Google Scholar 

  8. Stimmesse B, Barale F, Lassauge F, Truong Than T, Arbez-Gindre F, Adloff M, Succi C, Guichard C, Belon JP. Pharmacokinetics of methohexital administered rectally in pediatric anesthesia. Agressologie. 1987;28(10):1015–7. (French).

    Google Scholar 

  9. Michel-Guéroult P, Benoit I, Grellet J, Meynat Y, Merlet JP, Saux MC. Pharmacokinetic and clinical evaluation of rectal hydrophilic gel of methohexital in pediatric surgery. Therapie. 1993; 48(1):27–32. (French).

    Google Scholar 

  10. Liu LMP, Gaudreault P, Firedman PA. Methohexital plasma concentrations in children following rectal administration. Anesthesiology. 1985;62:567–70.

    PubMed  CAS  Google Scholar 

Midazolam

  1. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=22397&type=pdf&name=d6de628c-bbe5-437e-9338-6f54cd661be1. Accessed 11 Oct 2010.

Pharmacokinetics

  1. Johnson TN, Rostami-Hodjegan A, Tucker GT. Prediction of the clearance of eleven drugs and associated variability in neonates, infants and children. Clin Pharmacokinet. 2006;45(9):931–56.

    PubMed  CAS  Google Scholar 

  2. Minagawa K, Watanabe T. A pharmacokinetic study of midazolam for the treatment of status epilepticus in children: a preliminary report. No To Hattatsu. 2006;38(4):301–3.

    PubMed  CAS  Google Scholar 

  3. Björkman S. Prediction of drug disposition in infants and children by means of physiologically based pharmacokinetic (PBPK) modelling: theophylline and midazolam as model drugs. Br J Clin Pharmacol. 2005;59(6):691–704.

    PubMed  Google Scholar 

  4. de Wildt SN, de Hoog M, Vinks AA, van der Giesen E, van den Anker JN. Population pharmacokinetics and metabolism of midazolam in pediatric intensive care patients. Crit Care Med. 2003;31(7):1952–8.

    PubMed  Google Scholar 

  5. Johnson TN, Rostami-Hodjegan A, Goddard JM, Tanner MS, Tucker GT. Contribution of midazolam and its 1-hydroxy metabolite to preoperative sedation in children: a pharmacokinetic-pharmacodynamic analysis. Br J Anaesth. 2002;89(3):428–37.

    PubMed  CAS  Google Scholar 

  6. Reed MD, Rodarte A, Blumer JL, Khoo KC, Akbari B, Pou S, et al. The single-dose pharmacokinetics of midazolam and its primary metabolite in pediatric patients after oral and intravenous administration. J Clin Pharmacol. 2001;41(12):1359–69.

    PubMed  CAS  Google Scholar 

  7. Nahara MC, McMorrow J, Jones PR, Anglin D, Rosenberg R. Pharmacokinetics of midazolam in critically ill pediatric patients. Eur J Drug Metab Pharmacokinet. 2000;25(3–4):219–21.

    PubMed  CAS  Google Scholar 

  8. Blumer JL. Clinical pharmacology of midazolam in infants and children. Clin Pharmacokinet. 1998;35(1):37–47.

    PubMed  CAS  Google Scholar 

  9. Scott RC, Besag FM, Boyd SG, Berry D, Neville BG. Buccal absorption of midazolam: pharmacokinetics and EEG pharmacodynamics. Epilepsia. 1998;39(3):290–4.

    PubMed  CAS  Google Scholar 

  10. Jones RD, Visram AR, Kornberg JP, Irwin MG, Gunawardene WM. Premedication with oral midazolam in children – an assessment of psychomotor function, anxiolysis, sedation and pharmacokinetics. Anaesth Intensive Care. 1994;22(5):539–44.

    PubMed  CAS  Google Scholar 

  11. Malinovsky JM, Lejus C, Servin F, Lepage JY, Le Normand Y, Testa S, et al. Plasma concentrations of midazolam after i.v., nasal or rectal administration in children. Br J Anaesth. 1993;70(6):617–20.

    PubMed  CAS  Google Scholar 

  12. Tolia V, Brennan S, Aravind MK, Kauffman RE. Pharmacokinetic and pharmacodynamic study of midazolam in children during esophagogastroduodenoscopy. J Pediatr. 1991;119(3):467–71.

    PubMed  CAS  Google Scholar 

  13. Walbergh EJ, Wills RJ, Eckhert J. Plasma concentrations of midazolam in children following intranasal administration. Anesthesiology. 1991;74(2):233–5.

    PubMed  CAS  Google Scholar 

  14. Rey E, Delaunay L, Pons G, Murat I, Richard MO, Saint-Maurice C, et al. Pharmacokinetics of midazolam in children: comparative study of intranasal and intravenous administration. Eur J Clin Pharmacol. 1991;41(4):355–7.

    PubMed  CAS  Google Scholar 

  15. Kraus GB, Gruber RG, Knoll R, Danner U. Pharmacokinetic studies following intravenous and rectal administration of midazolam in children. Anaesthesist. 1989;38(12):658–63.

    PubMed  CAS  Google Scholar 

  16. Payne K, Mattheyse FJ, Liebenberg D, Dawes T. The pharmacokinetics of midazolam in paediatric patients. Eur J Clin Pharmacol. 1989;37(3):267–72.

    PubMed  CAS  Google Scholar 

  17. Mathews HM, Carson IW, Lyons SM, Orr IA, Collier PS, Howard PJ, et al. A pharmacokinetic study of midazolam in paediatric patients undergoing cardiac surgery. Br J Anaesth. 1988;61(3):302–7.

    PubMed  CAS  Google Scholar 

  18. Salonen M, Kanto J, Iisalo E, Himberg JJ. Midazolam as an induction agent in children: a pharmacokinetic and clinical study. Anesth Analg. 1987;66(7):625–8.

    PubMed  CAS  Google Scholar 

  19. Saint-Maurice C, Meistelman C, Rey E, Esteve C, de Lauture D, Olive G. The pharmacokinetics of rectal midazolam for premedication in children. Anesthesiology. 1986;65(5):536–8.

    PubMed  CAS  Google Scholar 

  20. Jochemsen R, Breimer DD. Pharmacokinetics of benzodiazepines: metabolic pathways and plasma level profiles. Curr Med Res Opin. 1984;8 Suppl 4:60–79.

    PubMed  CAS  Google Scholar 

Morphine

  1. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=18576&type=pdf&name=ad46c618-67e3-40fe-8ac7-57d567f454b3. Accessed 10 Oct 2010.

Pharmacokinetics

  1. Lugo RA, Kern SE. Clinical pharmacokinetics of morphine. J Pain Palliat Care Pharmacother. 2002;16(4):5–18.

    PubMed  Google Scholar 

  2. Mashayekhi SO, Ghandforoush-Sattari M, Routledge PA, Hain RD. Pharmacokinetic and pharmacodynamic study of morphine and morphine 6-glucuronide after oral and intravenous administration of morphine in children with cancer. Biopharm Drug Dispos. 2009;30(3):99–106.

    PubMed  CAS  Google Scholar 

  3. Peters JW, Anderson BJ, Simons SH, Uges DR, Tibboel D. Morphine pharmacokinetics during venoarterial extracorporeal membrane oxygenation in neonates. Intensive Care Med. 2005;31(2):257–63.

    PubMed  Google Scholar 

  4. Bouwmeester NJ, Anderson BJ, Tibboel D, Holford NH. Developmental pharmacokinetics of morphine and its metabolites in neonates, infants and young children. Br J Anaesth. 2004;92(2):208–17.

    PubMed  CAS  Google Scholar 

  5. Hunt A, Joel S, Dick G, Goldman A. Population pharmacokinetics of oral morphine and its glucuronides in children receiving morphine as immediate-release liquid or sustained-release tablets for cancer pain. J Pediatr. 1999;135(1):47–55.

    PubMed  CAS  Google Scholar 

  6. Hain RD, Hardcastle A, Pinkerton CR, Aherne GW. Morphine and morphine-6-glucuronide in the plasma and cerebrospinal fluid of children. Br J Clin Pharmacol. 1999;48(1):37–42.

    PubMed  CAS  Google Scholar 

  7. Kart T, Christrup LL, Rasmussen M. Recommended use of morphine in neonates, infants and children based on a literature review: part 1 – pharmacokinetics. Paediatr Anaesth. 1997;7(1):5–11.

    PubMed  CAS  Google Scholar 

  8. Lundeberg S, Beck O, Olsson GL, Boreus LO. Rectal administration of morphine in children. Pharmacokinetic evaluation after a single-dose. Acta Anaesthesiol Scand. 1996;40(4):445–51.

    PubMed  CAS  Google Scholar 

  9. Olkkola KT, Hamunen K, Maunuksela EL. Clinical pharmacokinetics and pharmacodynamics of opioid analgesics in infants and children. Clin Pharmacokinet. 1995;28(5):385–404.

    PubMed  CAS  Google Scholar 

  10. Dampier CD, Setty BN, Logan J, Ioli JG, Dean R. Intravenous morphine pharmacokinetics in pediatric patients with sickle cell disease. J Pediatr. 1995;126(3):461–7.

    PubMed  CAS  Google Scholar 

  11. Nichols DG, Yaster M, Lynn AM, Helfaer MA, Deshpande JK, Manson PN, Carson BS, Bezman M, Maxwell LG, Tobias JD, et al. Disposition and respiratory effects of intrathecal morphine in children. Anesthesiology. 1993; 79(4):733–8; discussion 25A.

    Google Scholar 

  12. Dagan O, Klein J, Bohn D, Barker G, Koren G. Morphine pharmacokinetics in children following cardiac surgery: effects of disease and inotropic ­support. J Cardiothorac Vasc Anesth. 1993;7(4):396–8.

    PubMed  CAS  Google Scholar 

  13. Choonara I, Lawrence A, Michalkiewicz A, Bowhay A, Ratcliffe J. Morphine metabolism in neonates and infants. Br J Clin Pharmacol. 1992;34(5):434–7.

    PubMed  CAS  Google Scholar 

  14. McRorie TI, Lynn AM, Nespeca MK, Opheim KE, Slattery JT. The maturation of morphine clearance and metabolism. Am J Dis Child. 1992; 146(8):972–6. Erratum in: Am J Dis Child. 1992;146(11):1305.

    Google Scholar 

  15. Nahata MC. Plasma concentrations of morphine in children with chronic pain–comparison of controlled release and regular morphine sulphate tablets. J Clin Pharm Ther. 1991;16(3):193–5.

    PubMed  CAS  Google Scholar 

  16. Choonara IA, McKay P, Hain R, Rane A. Morphine metabolism in children. Br J Clin Pharmacol. 1989;28(5):599–604.

    PubMed  CAS  Google Scholar 

  17. Attia J, Ecoffey C, Sandouk P, Gross JB, Samii K. Epidural morphine in children: pharmacokinetics and CO2 sensitivity. Anesthesiology. 1986;65(6):590–4.

    PubMed  CAS  Google Scholar 

  18. Shelly MP, Cory EP, Park GR. Pharmacokinetics of morphine in two children before and after liver transplantation. Br J Anaesth. 1986;58(11):1218–23.

    PubMed  CAS  Google Scholar 

  19. Nahata MC, Miser AW, Miser JS, Reuning RH. Variation in morphine pharmacokinetics in children with cancer. Dev Pharmacol Ther. 1985;8(3):182–8.

    PubMed  CAS  Google Scholar 

  20. Vandenberghe H, Mac Leod S, Chinyanga H, Endrenyi L, Soldin S. Pharmacokinetics of intravenous morphine in balanced anesthesia: studies in children. Drug Metab Rev. 1983;14(5):887–903.

    PubMed  CAS  Google Scholar 

Nitrous OxidePharmacokinetics

  1. Koren G, Sloan I. The pharmacokinetics of inhaled N2O in children. Res Commun Chem Pathol Pharmacol. 1985;49(1):95–108.

    PubMed  CAS  Google Scholar 

  2. O’Callaghan AC, Koren G, Sloan IA. Effects of age and cardiac shunts on the measured uptake of nitrous oxide in children. Res Commun Chem Pathol Pharmacol. 1991;74(3):299–315.

    PubMed  Google Scholar 

Clinical Application

  1. Mace SE, Brown LA, Francis L, Godwin SA, Hahn SA, Howard PK, Kennedy RM, Mooney DP, Sacchetti AD, Wears RL, Clark RM; EMSC Panel (Writing Committee) on Critical Issues in the Sedation of Pediatric Patients in the Emergency. Clinical policy: critical issues in the sedation of pediatric patients in the emergency department. Ann Emerg Med. 2008;51(4):378–99, 399.e1–57.

    Google Scholar 

  2. Babl FE, Oakley E, Seaman C, Barnett P, Sharwood LN. High-concentration nitrous oxide for procedural sedation in children: adverse events and depth of sedation. Pediatrics. 2008;121(3):e528–32.

    PubMed  Google Scholar 

  3. Bar-Meir E, Zaslansky R, Regev E, Keidan I, Orenstein A, Winkler E. Nitrous oxide administered by the plastic surgeon for repair of facial lacerations in children in the emergency room. Plast Reconstr Surg. 2006;117(5):1571–5.

    PubMed  CAS  Google Scholar 

  4. Luhmann JD, Schootman M, Luhmann SJ, Kennedy RM. A randomized comparison of nitrous oxide plus hematoma block versus ketamine plus midazolam for emergency department forearm fracture reduction in children. Pediatrics. 2006;118(4):e1078–86.

    PubMed  Google Scholar 

  5. Onody P, Gil P, Hennequin M. Safety of inhalation of a 50% nitrous oxide/oxygen premix: a prospective survey of 35 828 administrations. Drug Saf. 2006;29(7):633–40.

    PubMed  CAS  Google Scholar 

  6. Ekbom K, Jakobsson J, Marcus C. Nitrous oxide inhalation is a safe and effective way to facilitate procedures in paediatric outpatient departments. Arch Dis Child. 2005;90(10):1073–6.

    PubMed  CAS  Google Scholar 

  7. Burnweit C, Diana-Zerpa JA, Nahmad MH, Lankau CA, Weinberger M, Malvezzi L, et al. Nitrous oxide analgesia for minor pediatric surgical procedures: an effective alternative to conscious sedation? J Pediatr Surg. 2004;39(3):495–9. Discussion 495–9.

    PubMed  Google Scholar 

  8. Kanagasundaram SA, Lane LJ, Cavalletto BP, Keneally JP, Cooper MG. Efficacy and safety of nitrous oxide in alleviating pain and anxiety during painful procedures. Arch Dis Child. 2001;84(6):492–5.

    PubMed  CAS  Google Scholar 

  9. Luhmann JD, Kennedy RM, Porter FL, Miller JP, Jaffe DM. A randomized clinical trial of continuous-flow nitrous oxide and midazolam for sedation of young children during laceration repair. Ann Emerg Med. 2001;37(1):20–7.

    PubMed  CAS  Google Scholar 

  10. Burton JH, Auble TE, Fuchs SM. Effectiveness of 50% nitrous oxide/50% oxygen during laceration repair in children. Acad Emerg Med. 1998;5(2):112–7.

    PubMed  CAS  Google Scholar 

  11. Gregory PR, Sullivan JA. Nitrous oxide compared with intravenous regional anesthesia in pediatric forearm fracture manipulation. J Pediatr Orthop. 1996;16(2):187–91.

    PubMed  CAS  Google Scholar 

  12. Evans JK, Buckley SL, Alexander AH, Gilpin AT. Analgesia for the reduction of fractures in children: a comparison of nitrous oxide with intramuscular sedation. J Pediatr Orthop. 1995;15(1):73–7.

    PubMed  CAS  Google Scholar 

  13. Hennrikus WL, Shin AY, Klingelberger CE. Self-administered nitrous oxide and a hematoma block for analgesia in the outpatient reduction of fractures in children. J Bone Joint Surg Am. 1995;77(3):335–9.

    PubMed  CAS  Google Scholar 

  14. Hennrikus WL, Simpson RB, Klingelberger CE, Reis MT. Self-administered nitrous oxide analgesia for pediatric fracture reductions. J Pediatr Orthop. 1994;14(4):538–42.

    PubMed  CAS  Google Scholar 

  15. Henderson JM, Spence DG, Komocar LM, Bonn GE, Stenstrom RJ. Administration of nitrous oxide to pediatric patients provides analgesia for venous cannulation. Anesthesiology. 1990;72(2):269–71.

    PubMed  CAS  Google Scholar 

  16. Wattenmaker I, Kasser JR, McGravey A. Self-administered nitrous oxide for fracture reduction in children in an emergency room setting. J Orthop Trauma. 1990;4(1):35–8.

    PubMed  CAS  Google Scholar 

  17. Gamis AS, Knapp JF, Glenski JA. Nitrous oxide analgesia in a pediatric emergency department. Ann Emerg Med. 1989;18(2):177–81.

    PubMed  CAS  Google Scholar 

  18. Benedetti C, Chapman CR, Colpitts YH, Chen AC. Effect of nitrous oxide concentration on event-related potentials during painful tooth stimulation. Anesthesiology. 1982;56(5):360–4.

    PubMed  CAS  Google Scholar 

  19. Ruben H. Nitrous oxide analgesia in dentistry. Its use during 15 years in Denmark. Br Dent J. 1972;132(5):195–6.

    PubMed  CAS  Google Scholar 

  20. Parbrook GD. The levels of nitrous oxide analgesia. Br J Anaesth. 1967;39(12):974–82.

    PubMed  CAS  Google Scholar 

  21. Zier JL, Tarrago R, Liu M. Level of sedation with nitrous oxide for pediatric medical procedures. Anesth Analg. 2010;110(5):1399–405.

    PubMed  CAS  Google Scholar 

Pentobarbital

  1. Mason KP, Zurakowski D, Connor L, et al. Infant sedation for MR imaging and CT: oral versus intravenous pentobarbital. Radiology. 2004;233:723–28.

    PubMed  Google Scholar 

  2. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=19410&type=pdf&name=f302ddf5-0213-43b3-b6c1-b3edf2bafbcd. Accessed 11 Oct 2010.

Pharmacokinetics

  1. Schaible DH, Cupit GC, Swedlow DB, Rocci Jr ML. High-dose pentobarbital pharmacokinetics in hypothermic brain-injured children. J Pediatr. 1982;100(4):655–60.

    PubMed  CAS  Google Scholar 

  2. Wermeling DP, Blouin RA, Porter WH, Rapp RP, Tibbs PA. Pentobarbital pharmacokinetics in patients with severe head injury. Drug Intell Clin Pharm. 1987;21(5):459–63.

    PubMed  CAS  Google Scholar 

Propofol

  1. http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=14327. Accessed 11 Oct 2010.

Pharmacokinetics

  1. Engelhardt T, McCheyne AJ, Morton N, Karsli C, Luginbuehl I, Adeli K, et al. Clinical adaptation of a pharmacokinetic model of propofol plasma concentrations in children. Paediatr Anaesth. 2008;18(3):235–9.

    PubMed  Google Scholar 

  2. Allegaert K, Peeters MY, Verbesselt R, Tibboel D, Naulaers G, de Hoon JN, et al. Inter-individual variability in propofol pharmacokinetics in preterm and term neonates. Br J Anaesth. 2007;99(6):864–70.

    PubMed  CAS  Google Scholar 

  3. Mazoit JX. Pharmacokinetic/pharmacodynamic modeling of anesthetics in children: therapeutic implications. Paediatr Drugs. 2006;8(3):139–50.

    PubMed  Google Scholar 

  4. Shangguan WN, Lian Q, Aarons L, Matthews I, Wang Z, Chen X, et al. Pharmacokinetics of a single bolus of propofol in Chinese children of different ages. Anesthesiology. 2006;104(1):27–32.

    PubMed  CAS  Google Scholar 

  5. Zuppa AF, Helfaer MA, Adamson PC. Propofol pharmacokinetics. Pediatr Crit Care Med. 2003;4(1):124–5.

    PubMed  Google Scholar 

  6. Rigby-Jones AE, Nolan JA, Priston MJ, Wright PM, Sneyd JR, Wolf AR. Pharmacokinetics of propofol infusions in critically ill neonates, infants, and children in an intensive care unit. Anesthesiology. 2002;97(6):1393–400.

    PubMed  CAS  Google Scholar 

  7. Knibbe CA, Melenhorst-deJong G, Mestrom M, Rademaker CM, Reijnvaan AF, Zuideveld KP, et al. Pharmacokinetics and effects of propofol 6% for short-term sedation in paediatric patients following cardiac surgery. Br J Clin Pharmacol. 2002;54(4):415–22.

    PubMed  CAS  Google Scholar 

  8. Sakai T, Mi WD, Ebina T, Kudo T, Kudo M, Matsuki A. Pharmacokinetics of propofol and ketamine during and after total intravenous anesthesia with propofol, fentanyl and ketamine for pediatric patients. Masui. 1998;47(3):277–80.

    PubMed  CAS  Google Scholar 

  9. Reed MD, Yamashita TS, Marx CM, Myers CM, Blumer JL. A pharmacokinetically based propofol dosing strategy for sedation of the critically ill, mechanically ventilated pediatric patient. Crit Care Med. 1996;24(9):1473–81.

    PubMed  CAS  Google Scholar 

  10. Murat I, Billard V, Vernois J, Zaouter M, Marsol P, Souron R, et al. Pharmacokinetics of propofol after a single dose in children aged 1–3 years with minor burns. Comparison of three data analysis approaches. Anesthesiology. 1996;84(3):526–32.

    PubMed  CAS  Google Scholar 

  11. Raoof AA, van Obbergh LJ, Verbeeck RK. Propofol pharmacokinetics in children with biliary atresia. Br J Anaesth. 1995;74(1):46–9.

    PubMed  CAS  Google Scholar 

  12. Short TG, Aun CS, Tan P, Wong J, Tam YH, Oh TE. A prospective evaluation of pharmacokinetic model controlled infusion of propofol in paediatric patients. Br J Anaesth. 1994;72(3):302–6.

    PubMed  CAS  Google Scholar 

  13. Fisher DM. Propofol in pediatrics. Lessons in pharmacokinetic modeling. Anesthesiology. 1994;80(1):2–5.

    PubMed  CAS  Google Scholar 

  14. Kataria BK, Ved SA, Nicodemus HF, Hoy GR, Lea D, Dubois MY, et al. The pharmacokinetics of propofol in children using three different data analysis approaches. Anesthesiology. 1994;80(1):104–22.

    PubMed  CAS  Google Scholar 

  15. Shafer SL. Advances in propofol pharmacokinetics and pharmacodynamics. J Clin Anesth. 1993;5(6 Suppl 1): 14S–21S.

    PubMed  CAS  Google Scholar 

  16. Jones RD, Chan K, Andrew LJ, Lawson AD, Wong P. Comparative pharmacokinetics of propofol in Chinese adults and children. Methods Find Exp Clin Pharmacol. 1992;14(1):41–7.

    PubMed  CAS  Google Scholar 

  17. Jones RD, Chan K, Andrew LJ. Pharmacokinetics of propofol in children. Br J Anaesth. 1990;65(5):661–7.

    PubMed  CAS  Google Scholar 

  18. Saint-Maurice C, Cockshott ID, Douglas EJ, Richard MO, Harmey JL. Pharmacokinetics of propofol in young children after a single dose. Br J Anaesth. 1989;63(6):667–70.

    PubMed  CAS  Google Scholar 

  19. Vandermeersch E, Van Hemelrijck J, Byttebier G, Van Aken H. Pharmacokinetics of propofol during continuous infusion for pediatric anesthesia. Acta Anaesthesiol Belg. 1989;40(3):161–5.

    PubMed  CAS  Google Scholar 

Clinical Application

  1. Gemma M, de Vitis A, Baldoli C, Calvi MR, Blasi V, Scola E, et al. Functional magnetic resonance imaging (fMRI) in children sedated with propofol or midazolam. J Neurosurg Anesthesiol. 2009;21(3):253–8.

    PubMed  Google Scholar 

  2. Lightdale JR, Valim C, Newburg AR, Mahoney LB, Zgleszewski S, Fox VL. Efficiency of propofol versus midazolam and fentanyl sedation at a pediatric teaching hospital: a prospective study. Gastrointest Endosc. 2008;67(7):1067–75.

    PubMed  Google Scholar 

  3. Mallory MD, Baxter AL, Kost SI, Pediatric Sedation Research Consortium. Propofol vs pentobarbital for sedation of children undergoing magnetic resonance imaging: results from the Pediatric Sedation Research Consortium. Paediatr Anaesth. 2009;19(6):601–11.

    PubMed  Google Scholar 

  4. Pershad J, Wan J, Anghelescu DL. Comparison of propofol with pentobarbital/midazolam/fentanyl sedation for magnetic resonance imaging of the brain in children. Pediatrics. 2007;120(3):e629–36.

    PubMed  Google Scholar 

  5. Rai K, Hegde AM, Goel K. Sedation in uncooperative children undergoing dental procedures: a comparative evaluation of midazolam, propofol and ketamine. J Clin Pediatr Dent. 2007 Fall;32(1):1–4.

    PubMed  Google Scholar 

  6. Gottschling S, Meyer S, Krenn T, Reinhard H, Lothschuetz D, Nunold H, et al. Propofol versus midazolam/ketamine for procedural sedation in pediatric oncology. J Pediatr Hematol Oncol. 2005;27(9):471–6.

    PubMed  Google Scholar 

  7. Koroglu A, Teksan H, Sagir O, Yucel A, Toprak HI, Ersoy OM. A comparison of the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging. Anesth Analg. 2006;103(1):63–7.

    PubMed  CAS  Google Scholar 

  8. Mahmoud M, Gunter J, Donnelly LF, Wang Y, Nick TG, Sadhasivam S. A comparison of dexmedetomidine with propofol for magnetic resonance imaging sleep studies in children. Anesth Analg. 2009;109(3):745–53.

    PubMed  CAS  Google Scholar 

  9. Cravero JP, Beach ML, Blike GT, Gallagher SM, Hertzog JH, Pediatric Sedation Research Consortium. The incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium. Anesth Analg. 2009;108(3):795–804.

    PubMed  CAS  Google Scholar 

Remifentanil

  1. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=10899&type=pdf&name=dbc63b6e-f8c5-4fd0-8ec3-4f5e19125313. Accessed 11 Oct 2010.

Pharmacokinetics

  1. Ross AK, Davis PJ, Dear Gd GL, Ginsberg B, McGowan FX, Stiller RD, et al. Pharmacokinetics of remifentanil in anesthetized pediatric patients undergoing elective surgery or diagnostic procedures. Anesth Analg. 2001;93(6):1393–401.

    PubMed  CAS  Google Scholar 

  2. Davis PJ, Wilson AS, Siewers RD, Pigula FA, Landsman IS. The effects of cardiopulmonary bypass on remifentanil kinetics in children undergoing atrial septal defect repair. Anesth Analg. 1999;89(4):904–8.

    PubMed  CAS  Google Scholar 

Clinical Application

  1. Battershill AJ, Keating GM. Remifentanil: a review of its analgesic and sedative use in the intensive care unit. Drugs. 2006;66(3):365–85.

    PubMed  CAS  Google Scholar 

  2. Sammartino M, Garra R, Sbaraglia F, De Riso M, Continolo N. Remifentanil in children. Paediatr Anaesth. 2010;20(3):246–55.

    PubMed  Google Scholar 

  3. Marsh DF, Hodkinson B. Remifentanil in paediatric anaesthetic practice. Anaesthesia. 2009;64(3):301–8.

    PubMed  CAS  Google Scholar 

S-Ketamine

  1. Kharasch ED, Labroo R. Metabolism of ketamine stereoisomers by human liver microsomes. Anesthe­siology. 1992;77(6):1201–7.

    PubMed  CAS  Google Scholar 

Intranasal

  1. Weber F, Wulf H, el Saeidi G. Premedication with nasal s-ketamine and midazolam provides good conditions for induction of anesthesia in preschool children. Can J Anaesth. 2003;50(5):470–5.

    PubMed  Google Scholar 

Caudal Block

  1. Almenrader N, Passariello M, D’Amico G, Haiberger R, Pietropaoli P. Caudal additives for postoperative pain management in children: S(+)-ketamine and neostigmine. Paediatr Anaesth. 2005;15(2):143–7.

    PubMed  CAS  Google Scholar 

  2. Passariello M, Almenrader N, Canneti A, Rubeo L, Haiberger R, Pietropaoli P. Caudal analgesia in children: S(+)-ketamine vs S(+)-ketamine plus clonidine. Paediatr Anaesth. 2004;14(10):851–5.

    PubMed  CAS  Google Scholar 

  3. Martindale SJ, Dix P, Stoddart PA. Double-blind ­randomized controlled trial of caudal versus intravenous S(+)-ketamine for supplementation of caudal analgesia in children. Br J Anaesth. 2004;92(3):344–7.

    PubMed  CAS  Google Scholar 

  4. Weber F, Wulf H. Caudal bupivacaine and s(+)-ketamine for postoperative analgesia in children. Paediatr Anaesth. 2003;13(3):244–8.

    PubMed  Google Scholar 

  5. Hager H, Marhofer P, Sitzwohl C, Adler L, Kettner S, Semsroth M. Caudal clonidine prolongs analgesia from caudal S(+)-ketamine in children. Anesth Analg. 2002;94(5):1169–72.

    PubMed  CAS  Google Scholar 

  6. De Negri P, Ivani G, Visconti C, De Vivo P. How to prolong postoperative analgesia after caudal ­anaesthesia with ropivacaine in children: S-ketamine versus clonidine. Paediatr Anaesth. 2001;11(6):679–83.

    PubMed  Google Scholar 

  7. Marhofer P, Krenn CG, Plöchl W, Wallner T, Glaser C, Koinig H, et al. S(+)-ketamine for caudal block in paediatric anaesthesia. Br J Anaesth. 2000;84(3):341–5.

    PubMed  CAS  Google Scholar 

Rectal

  1. Heinrich M, Wetzstein V, Muensterer OJ, Till H. Conscious sedation: off-label use of rectal S(+)-ketamine and midazolam for wound dressing changes in paediatric heat injuries. Eur J Pediatr Surg. 2004;14(4):235–9.

    PubMed  CAS  Google Scholar 

  2. Marhofer P, Freitag H, Höchtl A, Greher M, Erlacher W, Semsroth M. S(+)-ketamine for rectal premedication in children. Anesth Analg. 2001;92(1):62–5.

    PubMed  CAS  Google Scholar 

  3. Tanaka M, Nishikawa T. Rectal S(+)-ketamine for pediatric premedication. Anesth Analg. 2001;93(5):1363–4.

    PubMed  CAS  Google Scholar 

Pharmacodynamics and Pharmacokinetics

  1. Herd DW, Anderson BJ, Keene NA, Holford NH. Investigating the pharmacodynamics of ketamine in children. Paediatr Anaesth. 2008;18(1):36–42.

    PubMed  Google Scholar 

  2. Weber F, Wulf H, Gruber M, Biallas R. S-ketamine and s-norketamine plasma concentrations after nasal and i.v. administration in anesthetized children. Paediatr Anaesth. 2004;14(12):983–8.

    PubMed  Google Scholar 

  3. Koinig H, Marhofer P, Krenn CG, Klimscha W, Wildling E, Erlacher W, et al. Analgesic effects of caudal and intramuscular S(+)-ketamine in children. Anesthesiology. 2000;93(4):976–80.

    PubMed  CAS  Google Scholar 

Sufentanil

  1. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=7929&type=pdf&name=39dc3695-dbf2-4783-b1bf-97237593f1c0. Accessed 11 Oct 2010.

Pharmacokinetics

  1. Guay J, Gaudreault P, Tang A, Goulet B, Varin F. Pharmacokinetics of sufentanil in normal children. Can J Anaesth. 1992;39(1):14–20.

    PubMed  CAS  Google Scholar 

  2. Davis PJ, Stiller RL, Cook DR, Brandom BW, Davin-Robinson KA. Pharmacokinetics of sufentanil in adolescent patients with chronic renal failure. Anesth Analg. 1988;67(3):268–71.

    PubMed  CAS  Google Scholar 

  3. Greeley WJ, de Bruijn NP, Davis DP. Sufentanil pharmacokinetics in pediatric cardiovascular patients. Anesth Analg. 1987;66(11):1067–72.

    PubMed  CAS  Google Scholar 

  4. Davis PJ, Cook DR, Stiller RL, Davin-Robinson KA. Pharmacodynamics and pharmacokinetics of high-dose sufentanil in infants and children undergoing cardiac surgery. Anesth Analg. 1987;66(3):203–8.

    PubMed  CAS  Google Scholar 

Flumazenil

  1. http://www.bedfordlabs.com/BedfordLabsWeb/products/inserts/Div-FMZ-P02.pdf. Accessed 26 Jan 2010.

  2. Weinbroum AA, Flaishon R, Sorkine P, Szold O, Rudick V. A risk-benefit assessment of flumazenil in the management of benzodiazepine overdose. Drug Saf. 1997;17(3):181–96.

    PubMed  CAS  Google Scholar 

Intranasal

  1. Heard C, Creighton P, Lerman J. Intranasal flumazenil and naloxone to reverse over-sedation in a child undergoing dental restorations. Paediatr Anaesth. 2009;19(8):795–7. Discussion 798–9.

    PubMed  Google Scholar 

  2. McGlone R, Fleet T, Durham S, Hollis S. A comparison of intramuscular ketamine with high dose intramuscular midazolam with and without intranasal flumazenil in children before suturing. Emerg Med J. 2001;18(1):34–8.

    PubMed  CAS  Google Scholar 

Rectal

  1. Haret D. Rectal Flumazenil can save the day. Paediatr Anaesth. 2008;18(4):352.

    PubMed  Google Scholar 

  2. Carbajal R, Simon N, Blanc P, Paupe A, Lenclen R, Oliver-Martin M. Rectal flumazenil to reverse midazolam sedation in children. Anesth Analg. 1996;82(4):895.

    PubMed  CAS  Google Scholar 

  3. Lopez-Herce J, Lopez de Sa E, Garcia de Frias E. Reversal of midazolam sedation with rectal flumazenil in children. Crit Care Med. 1994;22(7):1204.

    Google Scholar 

Pharmacokinetics

  1. Jones RD, Chan K, Roulson CJ, Brown AG, Smith ID, Mya GH. Pharmacokinetics of flumazenil and midazolam. Br J Anaesth. 1993;70(3):286–92.

    PubMed  CAS  Google Scholar 

  2. Scheepers LD, Montgomery CJ, Kinahan AM, Dunn GS, Bourne RA, McCormack JP. Plasma concentration of flumazenil following intranasal administration in children. 1. Can J Anaesth. 2000;47(2):120–4.

    PubMed  CAS  Google Scholar 

Naloxone

  1. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=1281&type=pdf&name=cedc622c-7f96-4fc8-a621-a5c602946396. Accessed 11 Oct 2010.

Pharmacokinetics

  1. Moreland TA, Brice JE, Walker CH, Parija AC. Naloxone pharmacokinetics in the newborn. Br J Clin Pharmacol. 1980;9(6):609–12.

    PubMed  CAS  Google Scholar 

  2. Stile IL, Fort M, Wurzburger RJ, Rodvold KA, Spector S, Hiatt IM, et al. The pharmacokinetics of naloxone in the premature newborn. Dev Pharmacol Ther. 1987;10(6):454–9.

    PubMed  CAS  Google Scholar 

  3. American Academy of Pediatrics Committee on Drugs. Naloxone dosage and route of administration for infants and children: addendum to emergency drug doses for infants and children. Pediatrics. 1990;86(3):484–5.

    Google Scholar 

Lidocaine

  1. Catterall WA, Mackie K. Local Anesthetics. In: Brunton LL, Lzo JS, Parker KL, editors. Goodman and Gilman’s the pharmacological basis of therapeutics. 11th ed. New York: McGraw-Hill; 2006. p. 377–9.

    Google Scholar 

Pharmacokinetics

  1. Burrows FA, Lerman J, LeDez KM, Strong HA. Pharmacokinetics of lidocaine in children with congenital heart disease. Can J Anaesth. 1991;38(2):196–200.

    PubMed  CAS  Google Scholar 

  2. Amitai Y, Zylber-Katz E, Avital A, Zangen D, Noviski N. Serum lidocaine concentrations in children during bronchoscopy with topical anesthesia. Chest. 1990;98(6):1370–3.

    PubMed  CAS  Google Scholar 

  3. Leopold A, Wilson S, Weaver JS, Moursi AM. Pharmacokinetics of lidocaine delivered from a transmucosal patch in children. Anesth Prog. 2002 Summer;49(3):82–7.

    PubMed  Google Scholar 

  4. Mazoit JX, Dalens BJ. Pharmacokinetics of local anaesthetics in infants and children. Clin Pharmacokinet. 2004;43(1):17–32.

    PubMed  CAS  Google Scholar 

  5. Kopecky EA, Jacobson S, Bch MB, Hubley P, Palozzi L, Clarke HM, et al. Safety and pharmacokinetics of EMLA in the treatment of postburn pruritus in pediatric patients: a pilot study. J Burn Care Rehabil. 2001;22(3):235–42.

    PubMed  CAS  Google Scholar 

  6. Elad S, Cohen G, Zylber-Katz E, Findler M, Galili D, Garfunkel AA, et al. Systemic absorption of lidocaine after topical application for the treatment of oral mucositis in bone marrow transplantation patients. J Oral Pathol Med. 1999;28(4):170–2.

    PubMed  CAS  Google Scholar 

  7. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=17313&type=pdf&name=89a4bd73-89f4-4fd7-2c9f-921e1da8f96b. Accessed 10 Oct 2010.

Ondansetron

  1. http://www.bedfordlabs.com/BedfordLabsWeb/products/inserts/Div-OND-P01.pdf. Accessed 10 Oct 2010.

Pharmacokinetics

  1. Mondick JT, Johnson BM, Haberer LJ, Sale ME, Adamson PC, Coté CJ, et al. Population pharmacokinetics of intravenous ondansetron in oncology and surgical patients aged 1–48 months. Eur J Clin Pharmacol. 2010;66(1):77–86.

    PubMed  CAS  Google Scholar 

  2. Spahr-Schopfer IA, Lerman J, Sikich N, Palmer J, Jorch U. Pharmacokinetics of intravenous ondansetron in healthy children undergoing ear, nose, and throat surgery. Clin Pharmacol Ther. 1995;58(3):316–21.

    PubMed  CAS  Google Scholar 

  3. de Alwis DP, Aarons L, Palmer JL. Population pharmacokinetics of ondansetron: a covariate analysis. Br J Clin Pharmacol. 1998;46(2):117–25.

    PubMed  Google Scholar 

Metoclopramide

  1. http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=7478. Accessed 22 Feb 2011.

Pharmacokinetics

  1. Vauzelle-Kervroedan F, Rey E, D’Athis P, Badoual J, Olive G, Pons G. Metoclopramide plasma concentration in neonates. Int J Clin Pharmacol Ther. 1997;35(11):519–21.

    PubMed  CAS  Google Scholar 

  2. Bateman DN, Craft AW, Nicholson E, Pearson AD. Dystonic reactions and the pharmacokinetics of metoclopramide in children. Br J Clin Pharmacol. 1983;15(5):557–9.

    PubMed  CAS  Google Scholar 

Scopolamine

  1. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=8678&type=pdf&name=4d705c57-fa98-46e0-97f3-38e1b0ada76b. Accessed 10 Oct 2010.

DiphenhydraminePharmacokinetics

  1. Simons KJ, Watson WT, Martin TJ, Chen XY, Simons FE. Diphenhydramine: pharmacokinetics and pharmacodynamics in elderly adults, young adults, and children. J Clin Pharmacol. 1990;30(7):665–71.

    PubMed  CAS  Google Scholar 

  2. Altman DF. Drugs used in gastrointestinal diseases. In: Katzung BG, editor. Basic and clinical pharmacology. 8th ed. New York: McGraw-Hill; 2001. p. 1064–76.

    Google Scholar 

  3. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=1029&type=pdf&name=8878f134-42b9-4c30-b240-2761b6b3aa5f. Accessed 10 Oct 2010.

DexamethasonePharmacokinetics

  1. Naylor MW, Greden JF, Alessi NE. Plasma dexamethasone levels in children given the dexamethasone suppression test. Biol Psychiatry. 1990;27(6):592–600.

    PubMed  CAS  Google Scholar 

  2. Young MC, Cook N, Read GF, Hughes IA. The pharmacokinetics of low-dose dexamethasone in congenital adrenal hyperplasia. Eur J Clin Pharmacol. 1989;37(1):75–7.

    PubMed  CAS  Google Scholar 

  3. Richter O, Ern B, Reinhardt D, Becker B. Pharmacokinetics of dexamethasone in children. Pediatr Pharmacol (New York). 1983;3(3–4):329–37.

    CAS  Google Scholar 

  4. http://dailymed.nlm.nih.gov/dailymed/getFile.cfm?id=2934&type=pdf&name=1495284d-750f-437e-8525-6834cccb78eb. Accessed 10 Oct 2010.

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Acknowledgments

The author wishes to acknowledge the invaluable contribution of Dr. Bo Kennedy to this chapter.

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  1. Department of Anesthesiology, Perioperative and Pain Medicine, Children’s Hospital Boston, Harvard Medical School, Boston, MA, USA

    Randy P. Prescilla MD (Assistant in Perioperative Anesthesia, Instructor in Anesthesia)

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  1. Director, Radiology Anesthesia, and Sedation, Associate Professor of Anesthesia, Children’s Hospital Boston, Boston, 02115, Massachusetts, USA

    Keira P. Mason

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Prescilla, R.P. (2012). Pharmacology and Clinical Application of Sedatives, Analgesics, and Adjuncts. In: Mason, K. (eds) Pediatric Sedation Outside of the Operating Room. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09714-5_8

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