PURPOSE: To compare the effectiveness of 2 medication regimens, @entity1875 / @entity3575 (P/F) and @entity3652 / @entity1363 (K/M), for brief orthopedic emergency department procedural sedation. This study was powered to compare @entity1054 ( @entity1054 ) and procedural distress as measured by the Observational Score of Behavioral Distress-revised (OSBD-r; range: 0-23.5 with 23.5 representing maximal distress). METHODS: We conducted a prospective, partially-blinded controlled comparative trial comparing intravenous P/F with K/M in a convenience sample of 113 @entity1 aged 3 to 18 years old undergoing orthopedic procedural sedation. All medications were administered by the intermittent intravenous bolus method. An independent sedation nurse recorded total sedation time and @entity1054 . Effectiveness was measured using 6 parameters: 1) @entity1 distress as assessed by independent blinded observers after videotape review using the OSBD-r; 2) orthopedic satisfaction score (Likert scale 1-5); 3) sedation nurse satisfaction score (Likert 1-5); 4) parental perception of procedural @entity158 using a 0 to 100 mm Visual Analog Scale with the upper limit being "most @entity158 "; 5) @entity1 recall of the procedure; and 6) 1 to 3 week follow-up. RESULTS: @entity1054 and total sedation time were significantly less in the P/F group than in the K/M group (33.4 minutes vs 23.2 minutes). The mean OSBD-r scores during manipulation were 0.084 and 0.278 for the K/M and P/F groups, respectively. Although this difference was statistically significant (95% confidence interval for the mean difference -0.34 to -0.048), both regimens were successful in keeping the scores low. There was no statistical difference between the groups in the other measures of effectiveness. There was a statistically significant difference between the groups in the occurrence of desaturation and late side effects. CONCLUSIONS: @entity1054 with P/F is shorter than with K/M. P/F is comparable to K/M in reducing procedural distress associated with @entity158 orthopedic procedures in the pediatric emergency department. Although @entity1875 has a greater potential of @entity1576 and airway obstruction as compared with @entity3652 , it offers some unique advantages including a quicker offset and smoother recovery profile.

Comparison of XXXX / @entity3575 versus @entity3652 / @entity1363 for brief orthopedic procedural sedation in a pediatric emergency department.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity3652 :: ('MESH:D007649', 'Chemical') :: ['ketamine'] @entity3575 :: ('MESH:D005283', 'Chemical') :: ['fentanyl'] @entity1875 :: ('MESH:D015742', 'Chemical') :: ['propofol'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain', 'painful'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['respiratory depression'] @entity1363 :: ('MESH:D008874', 'Chemical') :: ['midazolam'] @entity1054 :: ('MESH:D000377', 'Disease') :: ['RT', 'recovery times']
@entity1875 :: (MESH:D015742,Chemical) :: ['propofol']
