Lingering effects of versed for peds? - page 2

by brownbook 5,940 Views | 14 Comments

I work out patient surgery so were talking minor surgical procedures on basically healthy pediatric patients. For the sake of argument we will be magical nurses and KNOW the child is not in pain or having other medical... Read More


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    I do not work in the PACU but a lot our patients we see in clinic have conscious sedation for studies (VCUG's or need sedation for MRI's, scans etc). They routinely use versed/ketamine. I have seen some kids come out of it irritable and inconsolable, cryng. These kids should not have pain as they did not have surgery. I do not think there is any rhyme or reason who is going to wake up mad. I tell parents that they either wake up happy and are drunk and entertaining or they wake up really pi***d and irritable. I think that happens with any type of sedation/anesthesia. I remember when my mom had her endoscopy....she got Versed and woke up being very mean and nasty. She was acting so lucid that my Dad (an anesthesiologist) was SO angry at her for her behavior.... and she has NO memory of it. It was all the versed. The next day she was asking my dad why he was so angry at her. When he told her it was because of her behavior in the recovery room, she was like what???? I do not even remember BEING in the recovery room!
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    It is really agreed upon in my peds PACU that versed is not our friend! But honestly, I think its a crap chute. Some kiddos wake up crazy and others are nice and calm. You learn to appreciate the calm ones.

    Someone mentioned ketamine in a previous post... I hate ketamine. I have seen little ones scared out of their minds from that stuff in recovery. Poor kiddos.
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    There are lots of reasons for emergence delirium, if there was one drug that we could easily eliminate emergence delirium we would have stopped using it years ago. http://www.anesthesia-analgesia.org/.../104/1/84.full

    Here is good article discussing the various reasons for emergence delirium.
    azhiker96, OkieeRN, and GHGoonette like this.
  4. 1
    Quote from lady constance
    some times i take a bit of heat for quickly sedating patients waking up wild.. they seem to wake up mid dream, mid reccollection of some wretched memory and need to go back to sleep and wake up in a happier memory....but it has not ever failed me in 18 years.....and is a tecnique used often...
    I do the same thing. I quickly sedate them with a small amount of fentanyl once they are waking up. They go back to sleep and when the wake up its a world of a difference.
    azhiker96 likes this.
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    Interesting thread. As with adults kids act differently. We had 2- 4year old kids have Tymp and tubes both had same anesthesiologist and given same agents. 1 woke up and went home in an hour the other we had for 4 hours because he was wild and inconsolable by parents staff. In adults when we have a "wild" wake up our anesthesia routinely give them versed to go back to sleep and they usually wake up totally fine the 2nd time. We however didn't do that with the children in the same situation. Would be a good study.


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