E-DRUG: Sedation of children pre-op

[Tim Dodd <timdodd@brain.net.pk>]

E-DRUG: Sedation of children pre-op
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Dear e-druggers,

Can you help with this one?  We're reviewing our use of sedation in 
children undergoing minor procedures and want some advice or suggestions 
as to possible alternatives.  The criteria are that the medicine should be 
orally active, fast acting, short duration, available locally, able to be 
converted into full general anesthesia if needed without worry of central 
nervous system depression, and low emetic potential.

My list so far is trimeprazine and diazepam.  Problems with trimeprazine
regarding malignant hyperthermia, cardiovascular depression, and severe
respiratory depression.  Also associations with sudden infant death 
syndrome have lead U.K. manufacturers to delete indication for short-term 
sedation and not at all in children under 2 year. Diazepam is OK but not 
very quick acting making the coordination of the different departments 
difficult.

What about using adult regimens in children?  Could we use lorazepam 
buccal or oral, what would the dose be?

We're talking about children 6 months or older.

Thanks in advance.

Tim Dodd
Director of Pharmacy
Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan
email: timdodd@brain.net.pk

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