OBJECTIVES: To compare 2 doses of rectal @entity1363 , used for pediatric emergency department sedation, with regard to sedative efficacy and frequency of paradoxical @entity2146 . METHODS: @entity1 <or=48 months old undergoing cutaneous procedures received @entity1363 by rectum, randomized in double-blind fashion to standard (0.5 mg/kg, SDM) or high (1 mg/kg, HDM) doses. Behaviors were scored on a 5-point sedation scale before and during procedures. Proportions manifesting successful sedation and postprocedure @entity2146 were compared between the 2 doses. RESULTS: Sixty-five @entity1 (32 SDM, 33 HDM) underwent sedated procedures (repair of lacerations, 97%). Behavior scores improved for both groups following medication administration and at best sedation during procedure. HDM produced better sedation at time of first suture (successful sedation: 70%, SDM vs. 91%, HDM; intergroup difference = 21%; 95% confidence interval [CI] = 2, 41) and at best point during the procedure (72%, SDM vs. 97%, HDM; Delta = 25%; 95% CI = 8, 43). However, sedative efficacy declined such that only 50% and 73% of the SDM and HDM groups, respectively, had successful sedation at the worst point during the procedures. Postprocedure @entity2146 occurred in 17% of @entity1 (6%, SDM vs. 27%, HDM; Delta = 21%; 95% CI = 3, 39). CONCLUSIONS: Rectal @entity1363 improved sedation scores over preprocedure levels and was more effective with a dose of 1 mg/kg than with 0.5 mg/kg. However, inadequate sedation in 27-50% of @entity1 and prolonged @entity2146 in 27% of @entity1 at higher doses counter the advantages of rectal @entity1363 .

High-dose rectal XXXX for pediatric procedures: a randomized trial of sedative efficacy and @entity2146 .

@entity1 :: ('9606', 'Species') :: ['Children', 'patients'] @entity2146 :: ('MESH:D011595', 'Disease') :: ['agitation'] @entity1363 :: ('MESH:D008874', 'Chemical') :: ['midazolam']
@entity1363 :: (MESH:D008874,Chemical) :: ['midazolam']
