When slam-dunk sedation is needed - i.e. - no movement and guaranteed
hypnosis so the techs don't start playing ping-pong with the child - I use
pentobarbital 4-5 mg/kg IM as Jay wrote. It has always worked and I send a
PALS certified nurse(someone I trust) to bag the child if they desaturate
(which has never happened but it would if I didn't send a nurse).
When it is evening when childen are close to bed-time, low risk head injury,
CYA scan and I can tolerate a little motion artifact, this Cro-magnon man
still uses chloral hydrate 25-75 mg/kg po - works almost all the time.
I a proponent of rectal midazolam (0.5-0.7mg/kg) as long as it is absorbed by
mucosa and not stool. I am still unhappy with the lack of consistent results
with this drug for sedation.
As for methoxital, I agree with Marti - it works great and is very short
acting when used IV.
Enjoy the rest of the summer!
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