Associations with early vomiting when using intranasal fentanyl and nitrous oxide for procedural sedation in children: A secondary analysis of a randomised controlled trial

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-09-13 DOI:10.1111/1742-6723.14497

Emmanuelle Fauteux‐Lamarre, Stephen Hearps, Michelle McCarthy, Nuala Quinn, Andrew Davidson, Donna Legge, Katherine J Lee, Greta M Palmer, Sandy M Hopper, Franz E Babl

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引用次数: 0

Abstract

ObjectiveIntranasal (IN) fentanyl and nitrous oxide (N2O) can be combined to provide procedural sedation and analgesia to children. This combination is advantageous because of rapid onset of action and non‐parenteral administration, but is associated with increased vomiting. We sought to describe the associations of demographic and procedural factors with early vomiting when using this combination in children.MethodsThis was a planned secondary analysis of a randomised controlled trial comparing the effect of oral ondansetron versus placebo at a single paediatric hospital. Children aged 3 to <18 years with planned procedural sedation with IN fentanyl and N2O were randomised to receive oral ondansetron or placebo prior to N2O administration. Vomiting was defined as early if occurring during or up to 1 h after N2O delivery. We assessed the relationship between early vomiting, demographic and procedural characteristics.ResultsParticipants were recruited between October 2016 and January 2019 and 62 out of 436 (14%) had early vomiting. The risk of early vomiting was 30% higher with higher total dose of fentanyl, risk ratio = 1.3 (95% confidence interval = 1.004–1.59). There was little evidence of a relationship between the occurrence of early vomiting and sex, age, weight, type of procedure, fasting duration, time between fentanyl administration and start of procedure, and procedure duration.ConclusionWe found that higher doses of IN fentanyl were associated with higher risk of early vomiting when administered with N2O in children. Other factors did not appear to be associated with vomiting.

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使用鼻内芬太尼和氧化亚氮对儿童进行手术镇静时与早期呕吐的关系：随机对照试验的二次分析

目的经鼻（IN）芬太尼和氧化亚氮（N2O）可结合使用，为儿童提供手术镇静和镇痛。这种组合的优点是起效迅速且无需胃肠道给药，但会增加呕吐。我们试图描述在儿童中使用这种联合用药时，人口统计学因素和手术因素与早期呕吐的关系。方法这是一项随机对照试验的计划性二次分析，该试验比较了一家儿科医院口服昂丹司琼与安慰剂的效果。计划使用IN芬太尼和一氧化二氮进行手术镇静的3至18岁儿童在使用一氧化二氮前随机接受口服昂丹司琼或安慰剂。如果呕吐发生在N2O给药期间或给药后1小时内，则定义为早期呕吐。我们评估了早期呕吐、人口统计学特征和手术特征之间的关系。结果2016年10月至2019年1月期间招募了参与者，436人中有62人（14%）发生了早期呕吐。芬太尼总剂量越高，早期呕吐的风险越高30%，风险比=1.3（95%置信区间=1.004-1.59）。几乎没有证据表明早期呕吐的发生与性别、年龄、体重、手术类型、空腹时间、给予芬太尼与手术开始之间的时间以及手术持续时间有关。其他因素似乎与呕吐无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.