Delgado-Miguel Carlos, Miguel-Ferrero Miriam, Ezquerra Andrea, Díaz Mercedes, De Ceano-Vivas María, López-Gutiérrez Juan Carlos
Pediatric Burn Unit, Department of Pediatric Surgery, La Paz Children's Hospital, 28046 Madrid, Spain.
Institute for Health Research IdiPAZ, La Paz University Hospital, 28046 Madrid, Spain.
Children (Basel). 2023 Jun 30;10(7):1137. doi: 10.3390/children10071137.
The routine use of sedoanalgesia has increased the number of potential minor surgical procedures that can be performed in the Emergency Department (ED) without requiring general anesthesia and, thus, hospital admission. Our aim is to analyze the effectiveness and safety of the use of sedoanalgesia in childhood burns treated in the ED.
A retrospective study was conducted in burned children in whom burn debridement was performed under sedoanalgesia in the ED between 2017 and 2021 in a tertiary referral center for burns. We collected demographic variables, burn features and the type of sedoanalgesia performed in each case, including its effectiveness and associated adverse effects.
A total of 227 patients (118 males, 109 females) were included, with a median age of 25 months. In total, 99.2% of the burns were thermal (69.2% scald burns), with a mean total body surface area (TBSA) burned of 4%. The most commonly used drugs were intravenous ketamine (35.7%), intravenous ketamine + midazolam (15.4%), intranasal fentanyl + midazolam (14.1%) and intranasal fentanyl (10.6%). The effectiveness of sedoanalgesia was considered satisfactory in 95.2% of the cases, with an adverse effect rate of 7.5%, without severe adverse effects reported.
The use of sedoanalgesia in the ED in the early treatment of childhood burns achieves high effectiveness and safety. It is postulated as a quality indicator; thus, it should be known by all pediatric healthcare practitioners.
镇静镇痛的常规使用增加了可在急诊科（ED）进行的无需全身麻醉及住院的潜在小型外科手术的数量。我们的目的是分析在急诊科治疗儿童烧伤时使用镇静镇痛的有效性和安全性。
在一家三级烧伤转诊中心对2017年至2021年期间在急诊科接受镇静镇痛下烧伤清创的儿童烧伤患者进行了一项回顾性研究。我们收集了人口统计学变量、烧伤特征以及每例患者的镇静镇痛类型，包括其有效性和相关不良反应。
共纳入227例患者（118例男性，109例女性），中位年龄为25个月。总体而言，99.2%的烧伤为热烧伤（69.2%为烫伤），平均烧伤总面积（TBSA）为4%。最常用的药物是静脉注射氯胺酮（35.7%）、静脉注射氯胺酮+咪达唑仑（15.4%）、鼻内芬太尼+咪达唑仑（14.1%）和鼻内芬太尼（10.6%）。95.2%的病例中镇静镇痛效果被认为满意，不良反应发生率为7.5%，未报告严重不良反应。
在急诊科对儿童烧伤进行早期治疗时使用镇静镇痛具有较高的有效性和安全性。它被假定为一项质量指标；因此，所有儿科医疗从业者都应该了解。
