Timing of Opioids and Risk for Adverse Events During Pediatric Procedural Sedation

Administration of opioids prior to procedural sedation in children is associated with increased risk for adverse events. To determine whether the timing of opioid administration is associated with the degree of risk, researchers performed a secondary analysis of a prospective observational study of patients aged <18 years undergoing procedural sedation in six Canadian emergency departments (NEJM JW Emerg Med Oct 2017 and JAMA Pediatr 2017; 171:957).

Of 6295 patients in the parent study, 1806 received presedation opioids and were included in this analysis. Median age was 11 years; orthopedic reduction was the most common reason for sedation (89%). In regression analysis adjusted for potential confounders, adverse events were more likely the c…