{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T10:52:00Z","timestamp":1792839120921,"version":"4.5.0"},"reference-count":122,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,10,1]]},"abstract":"<jats:sec><jats:title>Objectives.<\/jats:title><jats:p>To perform a systematic investigation of medications associated with adverse sedation events in pediatric patients using critical incident analysis of case reports.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>One hundred eighteen case reports from the adverse drug reporting system of the Food and Drug Administration, the US Pharmacopoeia, and the results of a survey of pediatric specialists were used. Outcome measures were death, permanent neurologic injury, prolonged hospitalization without injury, and no harm. The overall results of the critical incident analysis are reported elsewhere. The current investigation specifically examined the relationship between outcome and medications: individual and classes of drugs, routes of administration, drug combinations and interactions, medication errors and overdoses, patterns of drug use, practitioners, and venues of sedation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Ninety-five incidents fulfilled study criteria and all 4 reviewers agreed on causation; 60 resulted in death or permanent neurologic injury. Review of adverse sedation events indicated that there was no relationship between outcome and drug class (opioids; benzodiazepines; barbiturates; sedatives; antihistamines; and local, intravenous, or inhalation anesthetics) or route of administration (oral, rectal, nasal, intramuscular, intravenous, local infiltration, and inhalation). Negative outcomes (death and permanent neurologic injury) were often associated with drug overdose (n = 28). Some drug overdoses were attributable to prescription\/transcription errors, although none of 39 overdoses in 34 patients seemed to be a decimal point error. Negative outcomes were also associated with drug combinations and interactions. The use of 3 or more sedating medications compared with 1 or 2 medications was strongly associated with adverse outcomes (18\/20 vs 7\/70). Nitrous oxide in combination with any other class of sedating medication was frequently associated with adverse outcomes (9\/10). Dental specialists had the greatest frequency of negative outcomes associated with the use of 3 or more sedating medications. Adverse events occurred despite drugs being administered within acceptable dosing limits. Negative outcomes were also associated with drugs administered by nonmedically trained personnel and drugs administered at home. Some injuries occurred on the way to a facility after administration of sedatives at home; some took place in automobiles or at home after discharge from medical supervision. Deaths and injuries after discharge from medical supervision were associated with the use of medications with long half-lives (chloral hydrate, pentobarbital, promazine, promethazine, and chlorpromazine).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions.<\/jats:title><jats:p>Adverse sedation events were frequently associated with drug overdoses and drug interactions, particularly when 3 or more drugs were used. Adverse outcome was associated with all routes of drug administration and all classes of medication, even those (such as chloral hydrate) thought to have minimal effect on respiration. Patients receiving medications with long plasma half-lives may benefit from a prolonged period of postsedation observation. Adverse events occurred when sedative medications were administered outside the safety net of medical supervision. Uniform monitoring and training standards should be instituted regardless of the subspecialty or venue of practice. Standards of care, scope of practice, resource management, and reimbursement for sedation should be based on the depth of sedation achieved (ie, the degree of vigilance and resuscitation skills required) rather than on the drug class, route of drug administration, practitioner, or venue.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.106.4.633","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:50:41Z","timestamp":1092441041000},"page":"633-644","source":"Crossref","is-referenced-by-count":488,"title":["Adverse Sedation Events in Pediatrics: Analysis of Medications Used for Sedation"],"prefix":"10.1542","volume":"106","author":[{"given":"Charles J.","family":"Cote\u0301","sequence":"first","affiliation":[{"name":"From the Department of Pediatric Anesthesiology, Children's Memorial Hospital, Northwestern University School of Medicine, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen W.","family":"Karl","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology, Children's Hospital, University of Washington School of Medicine, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Notterman","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, Princeton University, Princeton, New Jersey and the Division of Critical Care Medicine, New York Presbyterian Hospital, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Department of Emergency Services, LeBonheur Children's Medical Center and the Department of Pediatrics, University of Tennessee College of Medicine, Memphis Tennessee; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"McCloskey","sequence":"additional","affiliation":[{"name":"Food and Drug Administration, Center for Drug Evaluation and Research, Office of Post-Marketing Drug Risk Assessment, Division of Drug Risk Evaluation II, Washington, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2000,10,1]]},"reference":[{"key":"2021121009283312200_B1","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1542\/peds.105.4.805","article-title":"Adverse sedation events in pediatrics: a critical incident analysis of contributory factors.","volume":"105","author":"Cote\u0301","year":"2000","journal-title":"Pediatrics"},{"key":"2021121009283312200_B2","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1097\/00005650-199207000-00004","article-title":"Hospital and patient characteristics associated with death after surgery: a study of adverse occurrence and failure to rescue.","volume":"30","author":"Silber","year":"1992","journal-title":"Med Care"},{"key":"2021121009283312200_B3","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1001\/jama.1995.03530040045039","article-title":"Evaluation of the complication rate as a measure of quality of care in coronary artery bypass graft surgery.","volume":"274","author":"Silber","year":"1995","journal-title":"JAMA"},{"key":"2021121009283312200_B4","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/S0097-5990(16)30248-2","article-title":"Peer reviewer agreement for major anesthetic mishaps.","volume":"14","author":"Caplan","year":"1988","journal-title":"Qual Rev Bull"},{"key":"2021121009283312200_B5","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1002\/sim.4780090917","article-title":"Measuring interrater reliability among multiple raters: an example of methods for nominal data.","volume":"9","author":"Posner","year":"1990","journal-title":"Stat Med"},{"key":"2021121009283312200_B6"},{"key":"2021121009283312200_B7"},{"key":"2021121009283312200_B8"},{"key":"2021121009283312200_B9","doi-asserted-by":"crossref","first-page":"49","DOI":"10.2307\/2531629","article-title":"A note on case-control sampling to estimate kappa coefficients.","volume":"46","author":"Kraemer","year":"1990","journal-title":"Biometrics"},{"key":"2021121009283312200_B10","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1007\/BF02296208","article-title":"Ramifications of a population model for kappa as a coefficient of reliability.","volume":"44","author":"Kraemer","year":"1979","journal-title":"Psychometrika."},{"key":"2021121009283312200_B11","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data.","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"2021121009283312200_B12","doi-asserted-by":"crossref","first-page":"363","DOI":"10.2307\/2529786","article-title":"An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers.","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"2021121009283312200_B13","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1001\/jama.1995.03530010049034","article-title":"Systems analysis of adverse drug events. ADE Prevention Study Group.","volume":"274","author":"Leape","year":"1995","journal-title":"JAMA"},{"key":"2021121009283312200_B14","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/BF02600138","article-title":"Incidence and preventability of adverse drug events in hospitalized adults.","volume":"8","author":"Bates","year":"1993","journal-title":"J Gen Intern Med"},{"key":"2021121009283312200_B15","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1001\/jama.1995.03530010043033","article-title":"Incidence of adverse drug events and potential adverse drug events: implications for prevention. ADE Prevention Study Group.","volume":"274","author":"Bates","year":"1995","journal-title":"JAMA"},{"key":"2021121009283312200_B16","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/BF02600255","article-title":"Relationship between medication errors and adverse drug events.","volume":"10","author":"Bates","year":"1995","journal-title":"J Gen Intern Med"},{"key":"2021121009283312200_B17","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/S0097-5990(16)30608-X","article-title":"Preventing medical injury.","volume":"19","author":"Leape","year":"1993","journal-title":"Qual Rev Bull"},{"key":"2021121009283312200_B18"},{"key":"2021121009283312200_B19","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1002\/j.1552-4604.1994.tb01978.x","article-title":"Pediatric medication errors: predicting and preventing tenfold disasters.","volume":"34","author":"Koren","year":"1994","journal-title":"J Clin Pharmacol"},{"key":"2021121009283312200_B20"},{"key":"2021121009283312200_B21","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1001\/jama.1994.03520230061039","article-title":"Error in medicine.","volume":"272","author":"Leape","year":"1994","journal-title":"JAMA"},{"key":"2021121009283312200_B22","doi-asserted-by":"crossref","first-page":"2329","DOI":"10.1001\/jama.1990.03440170051035","article-title":"Medication prescribing errors in a teaching hospital.","volume":"263","author":"Lesar","year":"1990","journal-title":"JAMA"},{"key":"2021121009283312200_B23","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1093\/ajhp\/52.4.369","article-title":"Understanding and preventing drug misadventures: proceedings of a conference, Chantilly, Virginia, October 21\u201323, 1994.","volume":"52","author":"Anonymous","year":"1995","journal-title":"Am J Health Syst Pharm"},{"key":"2021121009283312200_B24","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1093\/ajhp\/52.4.379","article-title":"Preventing adverse drug events.","volume":"52","author":"Leape","year":"1995","journal-title":"Am J Health Syst Pharm"},{"key":"2021121009283312200_B25","first-page":"305","article-title":"ASHP guidelines on preventing medication errors in hospitals.","volume":"50","author":"Anonymous","year":"1993","journal-title":"Am J Hosp Pharm"},{"key":"2021121009283312200_B26","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1093\/ajhp\/56.3.215","article-title":"Responsibility for medication errors.","volume":"56","author":"Hasegawa","year":"1999","journal-title":"Am J Health Syst Pharm"},{"key":"2021121009283312200_B27","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1046\/j.1440-1762.1999.00285.x","article-title":"Frequency, consequences and prevention of adverse drug events.","volume":"19","author":"Bates","year":"1999","journal-title":"J Qual Clin Pract"},{"key":"2021121009283312200_B28","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1542\/peds.102.2.428","article-title":"Prevention of medication errors in the pediatric inpatient setting.","volume":"102","author":"American Academy of Pediatrics, Committee on Drugs, Committee on Hospital Care","year":"1998","journal-title":"Pediatrics"},{"key":"2021121009283312200_B29","first-page":"S38","article-title":"Computer-enhanced neonatology practice evolution in an academic medical center. NICU Clinical Effectiveness Task Force.","volume":"18","author":"Myers","year":"1998","journal-title":"J Perinatol"},{"key":"2021121009283312200_B30","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1001\/jama.282.3.267","article-title":"Pharmacist participation on physician rounds and adverse drug events in the intensive care unit.","volume":"282","author":"Leape","year":"1999","journal-title":"JAMA"},{"key":"2021121009283312200_B31","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1136\/jamia.1999.00660313","article-title":"The impact of computerized physician order entry on medication error prevention.","volume":"6","author":"Bates","year":"1999","journal-title":"J Am Med Inform Assoc"},{"key":"2021121009283312200_B32","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S1386-5056(98)00152-X","article-title":"Using information systems to measure and improve quality.","volume":"53","author":"Bates","year":"1999","journal-title":"Int J Med Inf"},{"key":"2021121009283312200_B33","first-page":"541","article-title":"The incident reporting system does not detect adverse drug events: a problem for quality improvement.","volume":"21","author":"Cullen","year":"1995","journal-title":"Jt Comm J Qual Improv"},{"key":"2021121009283312200_B34","first-page":"255","article-title":"Costs of medical injuries in Utah and Colorado.","volume":"36","author":"Thomas","year":"1999","journal-title":"Inquiry"},{"key":"2021121009283312200_B35","doi-asserted-by":"crossref","first-page":"221","DOI":"10.7326\/0003-4819-112-3-221","article-title":"Identification of adverse events occurring during hospitalization: a cross-sectional study of litigation, quality assurance, and medical records at two teaching hospitals.","volume":"112","author":"Brennan","year":"1990","journal-title":"Ann Intern Med"},{"key":"2021121009283312200_B36","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1056\/NEJM199102073240604","article-title":"Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I.","volume":"324","author":"Brennan","year":"1991","journal-title":"N Engl J Med"},{"key":"2021121009283312200_B37","first-page":"213","article-title":"Voluntary systems of adverse reaction reporting\u2014part I.","volume":"4","author":"Griffin","year":"1985","journal-title":"Adverse Drug React Acute Poisoning Rev"},{"key":"2021121009283312200_B38","first-page":"23","article-title":"Voluntary systems of adverse reaction reporting\u2014part II.","volume":"5","author":"Griffin","year":"1986","journal-title":"Adverse Drug React Acute Poisoning Rev"},{"key":"2021121009283312200_B39","first-page":"203","article-title":"Voluntary systems of adverse reaction reporting\u2014part III.","volume":"8","author":"Griffin","year":"1989","journal-title":"Adverse Drug React Acute Poisoning Rev"},{"key":"2021121009283312200_B40","first-page":"192","article-title":"Are medication error rates useful as comparative measures of organizational performance?","volume":"20","author":"van Leeuwen","year":"1994","journal-title":"Jt Comm J Qual Improv"},{"key":"2021121009283312200_B41","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3810\/pgm.1998.03.408","article-title":"MedWatch: FDA's Medical Products Reporting Program.","volume":"103","author":"Goldman","year":"1998","journal-title":"Postgrad Med"},{"key":"2021121009283312200_B42","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1093\/ajhp\/52.13.1436","article-title":"Reporting of adverse events to MedWatch.","volume":"52","author":"Piazza-Hepp","year":"1995","journal-title":"Am J Health Syst Pharm"},{"key":"2021121009283312200_B43","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1097\/00000542-199011000-00005","article-title":"Frequent hypoxemia and apnea after sedation with midazolam and fentanyl.","volume":"73","author":"Bailey","year":"1990","journal-title":"Anesthesiology"},{"key":"2021121009283312200_B44","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1111\/j.1399-6576.1987.tb02588.x","article-title":"Changes in breathing pattern and chest wall mechanics after benzodiazepines in combination with meperidine.","volume":"31","author":"Berggren","year":"1987","journal-title":"Acta Anaesthesiol Scand"},{"key":"2021121009283312200_B45","doi-asserted-by":"crossref","first-page":"2385","DOI":"10.1001\/jama.1982.03320420035028","article-title":"Risks to children from computed tomographic scan premedication.","volume":"247","author":"Mitchell","year":"1982","journal-title":"JAMA"},{"key":"2021121009283312200_B46","doi-asserted-by":"crossref","first-page":"239","DOI":"10.14219\/jada.archive.1983.0225","article-title":"Life-threatening reactions after pedodontic sedation: an assessment of narcotic, local anesthetic, and antiemetic drug interaction.","volume":"107","author":"Goodson","year":"1983","journal-title":"J Am Dent Assoc"},{"key":"2021121009283312200_B47","first-page":"39","article-title":"Major morbidity or mortality from office anesthetic procedures: a closed-claim analysis of 13 cases.","volume":"38","author":"Jastak","year":"1991","journal-title":"Anesth Prog"},{"key":"2021121009283312200_B48","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1542\/peds.98.1.118","article-title":"Is the \u201ctherapeutic orphan\u201d about to be adopted?","volume":"98","author":"Cote\u0301","year":"1996","journal-title":"Pediatrics"},{"key":"2021121009283312200_B49","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/S0022-3476(05)82409-6","article-title":"Fentanyl, fads, and folly: who will adopt the therapeutic orphans?","volume":"119","author":"Kauffman","year":"1991","journal-title":"J Pediatr"},{"key":"2021121009283312200_B50","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1002\/j.1552-4604.1994.tb01996.x","article-title":"Drug trials in children: ethical, legal, and practical issues.","volume":"34","author":"Kauffman","year":"1994","journal-title":"J Clin Pharmacol"},{"key":"2021121009283312200_B51","doi-asserted-by":"crossref","first-page":"308","DOI":"10.2165\/00003088-199426040-00006","article-title":"Paediatric labeling requirements: implications for pharmacokinetic studies.","volume":"26","author":"Wilson","year":"1994","journal-title":"Clin Pharmacokinet"},{"key":"2021121009283312200_B52","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1002\/j.1552-4604.1993.tb03945.x","article-title":"Pediatric pharmacology: the path clears for a noble mission.","volume":"33","author":"Wilson","year":"1993","journal-title":"J Clin Pharmacol"},{"key":"2021121009283312200_B53","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1046\/j.1440-1762.1999.00286.x","article-title":"A classification for adverse drug events.","volume":"19","author":"Malpass","year":"1999","journal-title":"J Qual Clin Pract"},{"key":"2021121009283312200_B54","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1034\/j.1399-6576.1999.430604.x","article-title":"Errors in the intensive care unit (ICU): experiences with an anonymous registration.","volume":"43","author":"Flaatten","year":"1999","journal-title":"Acta Anaesthesiol Scand"},{"key":"2021121009283312200_B55","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1542\/peds.70.3.447","article-title":"Chloral hydrate and the carbon dioxide chemoreceptor response: a study of puppies and infants.","volume":"70","author":"Lees","year":"1982","journal-title":"Pediatrics"},{"key":"2021121009283312200_B56","first-page":"171","article-title":"Chloral hydrate and its effects on multiple physiological parameters in young children: a dose-response study.","volume":"14","author":"Wilson","year":"1992","journal-title":"Pediatr Dent"},{"key":"2021121009283312200_B57","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/0305-4179(95)00013-5","article-title":"Seizure disorders in burned children: a retrospective review.","volume":"22","author":"Mukhdomi","year":"1996","journal-title":"Burns"},{"key":"2021121009283312200_B58","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1203\/00006450-198201001-00016","article-title":"Experimental effects of chloral hydrate on ventilatory response to hypoxia and hypercarbia.","volume":"16","author":"Hunt","year":"1982","journal-title":"Pediatr Res"},{"key":"2021121009283312200_B59","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/0735-6757(91)90105-S","article-title":"Chloral hydrate for emergent pediatric procedural sedation: a new look at an old drug.","volume":"9","author":"Binder","year":"1991","journal-title":"Am J Emerg Med"},{"key":"2021121009283312200_B60","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1177\/000992289203100302","article-title":"Sedation of children for technical procedures: current standard of practice.","volume":"31","author":"Cook","year":"1992","journal-title":"Clin Pediatr (Phila)"},{"key":"2021121009283312200_B61","doi-asserted-by":"crossref","first-page":"639","DOI":"10.2214\/ajr.161.3.8352124","article-title":"High-dose chloral hydrate sedation for children undergoing MR imaging: safety and efficacy in relation to age.","volume":"161","author":"Greenberg","year":"1993","journal-title":"AJR Am J Roentgenol"},{"key":"2021121009283312200_B62","doi-asserted-by":"crossref","first-page":"165","DOI":"10.2214\/ajr.163.1.8010205","article-title":"Sedation of difficult-to-sedate children undergoing MR imaging: value of thioridazine as an adjunct to chloral hydrate.","volume":"163","author":"Greenberg","year":"1994","journal-title":"AJR Am J Roentgenol"},{"key":"2021121009283312200_B63","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/BF00593395","article-title":"Randomized double-blind clinical trial of intermediate- versus high-dose chloral hydrate for neuroimaging of children.","volume":"37","author":"Marti-Bonmati","year":"1995","journal-title":"Neuroradiology"},{"key":"2021121009283312200_B64","doi-asserted-by":"crossref","first-page":"345","DOI":"10.14219\/jada.archive.1988.0235","article-title":"Death after chloral hydrate sedation: report of case.","volume":"116","author":"Jastak","year":"1988","journal-title":"J Am Dent Assoc"},{"key":"2021121009283312200_B65","doi-asserted-by":"crossref","first-page":"686","DOI":"10.5694\/j.1326-5377.1988.tb120823.x","article-title":"Overdose with chloral hydrate: a pharmacological and therapeutic review.","volume":"149","author":"Graham","year":"1988","journal-title":"Med J Aust"},{"key":"2021121009283312200_B66","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1159\/000457507","article-title":"Chloral hydrate toxicity in a term infant.","volume":"17","author":"Anyebuno","year":"1991","journal-title":"Dev Pharmacol Ther"},{"key":"2021121009283312200_B67","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3109\/15563659609020242","article-title":"Chloral hydrate toxicity from oral and intravenous administration.","volume":"34","author":"Sing","year":"1996","journal-title":"J Toxicol Clin Toxicol"},{"key":"2021121009283312200_B68","first-page":"277","article-title":"Relationship of tonsil size on an airway blockage maneuver in children during sedation.","volume":"19","author":"Fishbaugh","year":"1997","journal-title":"Pediatr Dent"},{"key":"2021121009283312200_B69","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/BF02019670","article-title":"Respiratory insufficiency following chloral hydrate sedation in two children with Leigh disease (subacute necrotizing encephalomyelopathy).","volume":"20","author":"Greenberg","year":"1990","journal-title":"Pediatr Radiol"},{"key":"2021121009283312200_B70","first-page":"461","article-title":"Adverse effect of chloral hydrate in two young children with obstructive sleep apnea.","volume":"92","author":"Biban","year":"1993","journal-title":"Pediatrics"},{"key":"2021121009283312200_B71","first-page":"905","article-title":"Chloral hydrate sedation in children undergoing CT and MR imaging: safety as judged by American Academy of Pediatrics (AAP) guidelines.","volume":"165","author":"Vade","year":"1995","journal-title":"Am J Radiol"},{"key":"2021121009283312200_B72","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1542\/peds.89.6.1110","article-title":"Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures.","volume":"89","author":"American Academy of Pediatrics, Committee on Drugs","year":"1992","journal-title":"Pediatrics"},{"key":"2021121009283312200_B73","first-page":"288","article-title":"Oxygen desaturation of selected term infants in car seats.","volume":"96","author":"Bass","year":"1995","journal-title":"Pediatrics"},{"key":"2021121009283312200_B74","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1159\/000480561","article-title":"Chloral hydrate disposition following single-dose administration to critically ill neonates and children.","volume":"16","author":"Mayers","year":"1991","journal-title":"Dev Pharm Ther"},{"key":"2021121009283312200_B75","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0196-0644(05)81114-X","article-title":"A prospective analysis of intramuscular meperidine, promethazine, and chlorpromazine in pediatric emergency department patients.","volume":"20","author":"Terndrup","year":"1991","journal-title":"Ann Emerg Med"},{"key":"2021121009283312200_B76","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1002\/cpt1977214437","article-title":"Pharmacokinetics of chlorpromazine after single and chronic dosage.","volume":"21","author":"Dahl","year":"1977","journal-title":"Clin Pharmacol Ther"},{"key":"2021121009283312200_B77","first-page":"1","article-title":"Chlorpromazine excretion by the neonate following chronic in utero exposure.","volume":"3","author":"Nielsen","year":"1983","journal-title":"Pediatr Pharmacol"},{"key":"2021121009283312200_B78","doi-asserted-by":"crossref","first-page":"329","DOI":"10.2165\/00003088-199018040-00005","article-title":"Chlorpromazine disposition in relation to age in children.","volume":"18","author":"Furlanut","year":"1990","journal-title":"Clin Pharmacokinet"},{"key":"2021121009283312200_B79","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1002\/bdd.2510110702","article-title":"Pharmacokinetics of promazine: disposition in patients with acute viral hepatitis B.","volume":"11","author":"Hu","year":"1990","journal-title":"Biopharm Drug Dispos"},{"key":"2021121009283312200_B80","doi-asserted-by":"crossref","first-page":"477","DOI":"10.2165\/00003088-198510060-00002","article-title":"Clinical pharmacokinetics of H1-receptor antagonists (the antihistamines).","volume":"10","author":"Paton","year":"1985","journal-title":"Clin Pharmacokinet"},{"key":"2021121009283312200_B81","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/0091-6749(84)90486-X","article-title":"The pharmacokinetics and antihistaminic of the H1 receptor antagonist hydroxyzine.","volume":"73","author":"Simons","year":"1984","journal-title":"J Allergy Clin Immunol"},{"key":"2021121009283312200_B82","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0022-3476(84)80608-3","article-title":"Pharmacokinetics and antipruritic effects of hydroxyzine in children with atopic dermatitis.","volume":"104","author":"Simons","year":"1984","journal-title":"J Pediatr"},{"key":"2021121009283312200_B83","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/S0022-3476(82)80780-4","article-title":"High-dose pentobarbital pharmacokinetics in hypothermic brain- injured children.","volume":"100","author":"Schaible","year":"1982","journal-title":"J Pediatr"},{"key":"2021121009283312200_B84","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/S0196-0644(89)80838-8","article-title":"Intramuscular meperidine, promethazine, and chlorpromazine: analysis of use and complications in 487 pediatric emergency department patients.","volume":"18","author":"Terndrup","year":"1989","journal-title":"Ann Emerg Med"},{"key":"2021121009283312200_B85","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1016\/S0031-3955(16)36768-2","article-title":"Lytic\/\u201cDPT\u201d cocktail: time for rational and safe alternatives.","volume":"36","author":"Snodgrass","year":"1989","journal-title":"Pediatr Clin North Am"},{"key":"2021121009283312200_B86","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/00006565-198712000-00002","article-title":"Outpatient pediatric analgesia-a tale of two regimens.","volume":"3","author":"Ros","year":"1987","journal-title":"Pediatr Emerg Care"},{"key":"2021121009283312200_B87"},{"key":"2021121009283312200_B88","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1001\/archpedi.1996.02170320017002","article-title":"Levels of consciousness and ventilatory parameters in young children during sedation with oral midazolam and nitrous oxide.","volume":"150","author":"Litman","year":"1996","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2021121009283312200_B89","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1213\/00000539-199804000-00009","article-title":"Chloral hydrate sedation: the additive sedative and respiratory depressant effects of nitrous oxide.","volume":"86","author":"Litman","year":"1998","journal-title":"Anesth Analg"},{"key":"2021121009283312200_B90","first-page":"318","article-title":"Upper airway obstruction during midazolam\/nitrous oxide sedation in children with enlarged tonsils.","volume":"20","author":"Litman","year":"1998","journal-title":"Pediatr Dent"},{"key":"2021121009283312200_B91","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/S0278-2391(97)90630-3","article-title":"Breathing patterns and levels of consciousness in children during administration of nitrous oxide after oral midazolam premedication.","volume":"55","author":"Litman","year":"1997","journal-title":"J Oral Maxillofac Surg"},{"key":"2021121009283312200_B92"},{"key":"2021121009283312200_B93","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1097\/00000542-199602000-00029","article-title":"Practice guidelines for sedation and analgesia by non-anesthesiologists: a report by the American Society of Anesthesiologists, Task Force on Sedation and Analgesia by Non-anesthesiologists.","volume":"84","author":"Gross","year":"1996","journal-title":"Anesthesiology"},{"key":"2021121009283312200_B94"},{"key":"2021121009283312200_B95","doi-asserted-by":"crossref","first-page":"422","DOI":"10.2165\/00003088-198308050-00004","article-title":"Clinical pharmacokinetics of fentanyl and its newer derivatives.","volume":"8","author":"Mather","year":"1983","journal-title":"Clin Pharmacokinet"},{"key":"2021121009283312200_B96","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1038\/clpt.1980.138","article-title":"Intravenous fentanyl kinetics.","volume":"28","author":"McClain","year":"1980","journal-title":"Clin Pharmacol Ther"},{"key":"2021121009283312200_B97","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1213\/00000539-199801000-00013","article-title":"Premedication of pediatric tonsillectomy patients with oral transmucosal fentanyl citrate.","volume":"86","author":"Dsida","year":"1998","journal-title":"Anesth Analg"},{"key":"2021121009283312200_B98","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1159\/000457538","article-title":"Age-related morphine kinetics in infants.","volume":"20","author":"Pokela","year":"1993","journal-title":"Dev Pharmacol Ther"},{"key":"2021121009283312200_B99","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1002\/cpt197824152","article-title":"Kinetics of intravenous and intramuscular morphine.","volume":"24","author":"Stanski","year":"1978","journal-title":"Clin Pharmacol Ther"},{"key":"2021121009283312200_B100","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1038\/clpt.1985.5","article-title":"Effects of age on meperidine disposition.","volume":"37","author":"Herman","year":"1985","journal-title":"Clin Pharmacol Ther"},{"key":"2021121009283312200_B101","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1093\/bja\/71.6.823","article-title":"Pharmacokinetics of i.v. and rectal pethidine in children undergoing ophthalmic surgery.","volume":"71","author":"Hamunen","year":"1993","journal-title":"Br J Anaesth"},{"key":"2021121009283312200_B102","first-page":"451","article-title":"Pethidine pharmacokinetics after intramuscular dose: a comparison in Caucasian, Chinese and Nepalese patients.","volume":"14","author":"Houghton","year":"1992","journal-title":"Methods Find Exp Clin Pharmacol"},{"key":"2021121009283312200_B103","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/S0009-9236(97)90100-4","article-title":"Pharmacokinetics and ventilatory effects of oxycodone before and after liver transplantation.","volume":"61","author":"Tallgren","year":"1997","journal-title":"Clin Pharmacol Ther"},{"key":"2021121009283312200_B104","first-page":"1772","article-title":"Pharmacokinetics of ketamine and pentazocine during total intravenous anesthesia with droperidol, pentazocine and ketamine.","volume":"41","author":"Kudo","year":"1992","journal-title":"Masui"},{"key":"2021121009283312200_B105","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/0002-9378(86)90822-7","article-title":"Pharmacokinetics of nalbuphine during parturition.","volume":"155","author":"Wilson","year":"1986","journal-title":"Am J Obstet Gynecol"},{"key":"2021121009283312200_B106","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1046\/j.1365-2125.1996.03642.x","article-title":"Disposition of diazepam in young and elderly subjects after acute and chronic dosing.","volume":"42","author":"Herman","year":"1996","journal-title":"Br J Clin Pharmacol"},{"key":"2021121009283312200_B107","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1172\/JCI107938","article-title":"The effects of age and liver disease on the disposition and elimination of diazepam in adult man.","volume":"55","author":"Klotz","year":"1975","journal-title":"J Clin Invest"},{"key":"2021121009283312200_B108","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1159\/000137524","article-title":"Diazepam kinetics in relation to age and sex.","volume":"23","author":"Ochs","year":"1981","journal-title":"Pharmacology"},{"key":"2021121009283312200_B109","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/BF00679782","article-title":"The pharmacokinetics of midazolam in paediatric patients.","volume":"37","author":"Payne","year":"1989","journal-title":"Eur J Clin Pharmacol"},{"key":"2021121009283312200_B110","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/BF00314967","article-title":"Pharmacokinetics of midazolam in children: comparative study of intranasal and intravenous administration.","volume":"41","author":"Rey","year":"1991","journal-title":"Eur J Clin Pharmacol"},{"key":"2021121009283312200_B111","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1093\/bja\/59.5.548","article-title":"Pharmacokinetics of midazolam in total i.v. anaesthesia.","volume":"59","author":"Persson","year":"1987","journal-title":"Br J Anaesth"},{"key":"2021121009283312200_B112","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/BF00562804","article-title":"The pharmacokinetics of midazolam in man.","volume":"19","author":"Smith","year":"1981","journal-title":"Eur J Clin Pharmacol"},{"key":"2021121009283312200_B113"},{"key":"2021121009283312200_B114","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1002\/j.1552-4604.1990.tb01871.x","article-title":"Diphenhydramine: pharmacokinetics and pharmacodynamics in elderly adults, young adults, and children.","volume":"30","author":"Simons","year":"1990","journal-title":"J Clin Pharmacol"},{"key":"2021121009283312200_B115","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1097\/00000542-198412000-00007","article-title":"The pharmacokinetics of thiopental in pediatric surgical patients.","volume":"61","author":"Sorbo","year":"1984","journal-title":"Anesthesiology"},{"key":"2021121009283312200_B116","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1093\/bja\/59.12.1541","article-title":"Pharmacokinetics of i.v. and rectal methohexitone in children.","volume":"59","author":"Bjorkman","year":"1987","journal-title":"Br J Anaesth"},{"key":"2021121009283312200_B117","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/BF01651461","article-title":"Comparison of intraarterial with continuous noninvasive blood pressure measurement in postoperative pediatric patients.","volume":"10","author":"Triedman","year":"1994","journal-title":"J Clin Monit"},{"key":"2021121009283312200_B118","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1097\/00000542-199909000-00020","article-title":"Ritonavir's role in reducing fentanyl clearance and prolonging its half-life.","volume":"91","author":"Olkkola","year":"1999","journal-title":"Anesthesiology"},{"key":"2021121009283312200_B119","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1111\/j.1365-2125.1994.tb04266.x","article-title":"Dose of midazolam should be reduced during diltiazem and verapamil treatments.","volume":"37","author":"Backman","year":"1994","journal-title":"Br J Clin Pharmacol"},{"key":"2021121009283312200_B120","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1093\/bja\/65.6.826","article-title":"Unconsciousness associated with midazolam and erythromycin.","volume":"65","author":"Hiller","year":"1994","journal-title":"Br J Anaesth"},{"key":"2021121009283312200_B121","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1007\/BF00196114","article-title":"A pharmacokinetic interaction between roxithromycin and midazolam.","volume":"46","author":"Backman","year":"1994","journal-title":"Eur J Clin Pharmacol"},{"key":"2021121009283312200_B122","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1038\/clpt.1993.25","article-title":"A potentially hazardous interaction between erythromycin and midazolam.","volume":"53","author":"Olkkola","year":"1993","journal-title":"Clin Pharmacol Ther"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/106\/4\/633\/843341\/633.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/106\/4\/633\/843341\/633.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T05:32:02Z","timestamp":1682746322000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/106\/4\/633\/65823\/Adverse-Sedation-Events-in-Pediatrics-Analysis-of"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,10,1]]},"references-count":122,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2000,10,1]]},"published-print":{"date-parts":[[2000,10,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.106.4.633","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[2000,10,1]]}}}