On January 31, Daniel Joyce said:
PO/IN/PR sedation does not work for potentially painful procedures
with any degree of reliability - c'mon, let's be honest. b) having an IV
in place is safer - with narcan, flumazenil, etc.
While no one would disagree with b, there is little data to support your
contention that oral, nasal, and rectal administration of a variety of
agents "does not work for potentially painful procedures". In fact, there
is evidence to the contrary in a variety of medical literature, including
anesthesiology, emergency medicine, pediatric, and other sources.
In particular in children with uncomplicated lacerations, we and others
have found and reported that midazolam is effective in reducing anxiety
and improving cooperation. That's honesty!!
What do members of the list feel is the principal objective in adminis-
tering a sedative/anxiolytic to children with lacerations? Is it a
reduction in anxiety, improved cooperation, coma, immobility?
Tom Terndrup, MD
SUNY Health Science Center at Syracuse