Author(s)

Nirupama Kannikeswaran^1*, Ahmad Farooqi², Cindy Chidi², Deepak Kamat¹

¹Carman and Ann Adam Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, USA.
²Wayne State University School of Medicine, Detroit, MI, USA.

Objective: To compare sedation efficacy and parent/consultant satisfaction between standard sedation, sedation with music listening, and sedation with Certified Child life Specialists (CCLS) in children undergoing procedural sedation in the Pediatric Emergency Department (PED). Methods: Eligible children, aged 3 - 18 years, were randomly allocated to one of 3 groups: 1) standard sedation; 2) sedation with music listening; 3) sedation with CCLS intervention. All 3 groups received intravenous ketamine. The child life group received age appropriate comforting measures, while the music group listened to music of their choice during the procedure. The primary outcome was sedation efficacy, measured by Ramsay Sedation scale, FACES-P scale and need for re-dosing. The secondary outcome was parent/consultant satisfaction. Results: Fifty nine patients were analyzed (standard sedation: 20; sedation with music listening: 20; and sedation with CCLS: 19). There was no significant difference in mean initial ketamine dosing (1.58 ± 0.44 vs. 1.68 ± 0.36 vs. 1.42 ± 0.47, p = 0.26). There was no significant difference in median Ramsay Sedation scores [6(IQR:4,6) vs. 6 (IQR:4,6) vs. 6 (IQR:5,6)], FACES-R pain score [0 (IQR:0.0) vs. 0 (IQR:0.0) vs. 0 (IQR:0.0)] and need for re-dosing [9/20 (45%) vs. 4/20 (20%) vs. 8/19 (42.1%)] amongst the 3 groups. Parent and consultant satisfaction was high in all 3 groups. Conclusion: Our pilot study did not demonstrate a difference in sedation efficacy or parent/consultant satisfaction when adjunct therapies were used during PSA. Further studies with a large sample size are needed to define the role for such adjunct therapies during procedural sedation in PED.

Procedural Sedation, Music Therapy, Certified Child Life Specialists, Emergency Department, Children

Kannikeswaran, N. , Farooqi, A. , Chidi, C. and Kamat, D. (2017) Procedural Sedation and Analgesia in Children in Emergency Department—Role of Adjunct Therapies. Open Journal of Anesthesiology, 7, 371-380. doi: 10.4236/ojanes.2017.711038.