Emergency Department Management of Pain and Anxiety Related to Orthopedic Fracture Care: A Guide to Analgesic Techniques and Procedural Sedation in Children

Research output: Contribution to journalReview article

73 Scopus citations

Abstract

Orthopedic fractures and joint dislocations are among the most painful pediatric emergencies. Safe and effective management of fracture-related pain and anxiety in the emergency department reduces patient distress during initial evaluation and often allows definitive management of the fracture. No consensus exists on which pharmacologic regimens for procedural sedation/analgesia are safest and most effective. For some children, control of fracture pain is the primary goal, whereas for others, relief from anxiety is an additionally important objective. Furthermore, strategies for the management of fracture pain may vary by fracture location and patient characteristics; thus, no single regimen is likely to provide the best means of analgesia and anxiolysis for all patients. Effective analgesia can be provided by local or regional anesthesia, such as hematoma, Bier, or nerve blocks. Alternatively, induction of deep sedation with analgesic agents such as ketamine of fentanyl, often combined with sedative-anxiolytic agents such as midazolam, may be used to manage distress associated with fracture reduction. A combination of local anesthesia with moderate sedation, for example nitrous oxide, is another attractive option.

Original languageEnglish
Pages (from-to)11-31
Number of pages21
JournalPediatric Drugs
Volume6
Issue number1
DOIs
StatePublished - Mar 16 2004

Fingerprint Dive into the research topics of 'Emergency Department Management of Pain and Anxiety Related to Orthopedic Fracture Care: A Guide to Analgesic Techniques and Procedural Sedation in Children'. Together they form a unique fingerprint.

  • Cite this