The Efficacy of Rectal Thiopental According to the Enema Positions for Pediatric Sedation

Lee, Ji Sook; Ahn, Kyoung Chan; Lee, Won Cheol; Choi, Sang Cheon; Ahn, Jung Hwan; Lee, Kug Jong; Kim, Gi Woon

Abstract

PURPOSE
We wanted to compare the efficacy of rectal thiopental according to the enema position for pediatric sedation in the emergency department
METHODS
One hundred sixty patients were sedated with rectal thiopental for CT or laceration repairs. The dosage of thiopental was 25 mg/kg and second dose was 15 mg/kg if the patient was not sedated. After administration, one group was positioned erect for 5 minutes and other group was positioned supine for 5 minutes. After the patients were sedated, we checked the Ramsay scales and the FLACC scales during compression by a BP cuff and/or injection of local anesthetics. All the patients were monitored for their oxygen saturation and their vital signs
RESULTS
Successful sedations and adequate procedures were obtained in each group: 95.2% in the erect group and 94.7% in the supine group. The induction time and recovery time after the first injected dose were not significantly different between the groups: 16+/-6 min and 57+/-3 min in the erect group and 16+/-8 min, 61+/-4 min in the supine group. After second dose injection, the induction and recovery time were not different between both groups. The Ramsay scale and FLACC scale during compression by a BP cuff were not different in the two groups. As compared to the FLACC scale for measuring pain during injecting local anesthetics to repair lacerations, the percentage of patients who had their pain recorded via the FLACC pain scale as 0 were different; 25.9% in a erect group and 4.5% in a supine group. But the difference between the groups was not significat (p=0.1). There were no significant side effects during the total sedations.
CONCLUSION
The efficacy when administrating rectal thiopental was not significantly different as related to the enema positions.