A comparison of intranasal sufentanil and midazolam to intramuscular meperidine, promethazine, and chlorpromazine for conscious sedation in children.

STUDY OBJECTIVE

To compare intranasal sufentanil and midazolam (IN-SM) with intramuscular meperidine, promethazine, and chlorpromazine (IM-MPC) for sedation in children.

DESIGN

Single-blind, randomized, controlled study.

SETTING

Urban children's emergency department.

PARTICIPANTS

A convenience sample of children aged 1 to 4 years requiring suturing.

INTERVENTIONS

IN-SM or IM-MPC.

RESULTS

Vital signs, O2 saturation, and anxiety and pain scores were recorded. A 6-point scale was used to assess response to medication, and a 12-point recovery score was used to determine readiness for discharge. Both groups were similar in age and sex distribution. There were no significant adverse effects in either group. Patients tolerated the IN regimen better than the IM regimen. Behavioral scores were lower during repair than at baseline within each group; however, they were not different between groups. Time to discharge was longer and recovery scores were lower (worse) among the IM-MPC group.

CONCLUSION

IN-SM is as effective as IM-MPC for sedation in children.