Conscious sedation for pediatric orthopaedic emergencies

The objective of this study was to assess complications and risk factors among children undergoing conscious sedation (CS) with fentanyl (F) and midazolam (M) for reduction of fractures and dislocations. A 22-month retrospective review was made of an urban pediatric emergency departmentʼs records after implementing a CS protocol for the administration of F/M. Data collection was facilitated by standard CS forms, and data were analyzed using descriptive statistics, x analysis, Fisherʼs exact test, t test, odds ratio, and logistic regression. A total of 339 children (65% boys), mean age of 8.4 years, were enrolled in the study. The mean time to sedation was 11.3 ± 6.2 minutes and to discharge was 92 ±36.3 minutes. The mean total doses of M and F were 0.17 ± 0.08 mg/kg and 1.5 ± 0.8 µg/ kg, respectively. An alteration in respiratory status occurred in 37 (11.0%) patients28 (8.3%) had oxygen saturation