SynthesisItalian journal of pediatrics2026
A comprehensive systematic review and meta-analysis of the safety of procedural sedation in pediatric emergency rooms.
Synthesis in Italian journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Paediatric Procedural Sedation and Analgesia in Emergency Departments: A Delphi Consensus Study.Emergency medicine Australasia : EMA · 2026Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn pediatric emergency departments (PEDs), procedural sedation is frequently used to reduce pain and anxiety to support therapeutic and diagnostic procedures. The purpose of this meta-analysis was to evaluate the safety profiles of common sedatives in the setting of PEDs.
methodsAn extensive search of four databases was conducted to identify studies reporting adverse effects associated with procedural sedation in pediatric emergency settings. Studies that reported on sedation-related outcomes and involved patients younger than 18 were considered eligible. A proportionate meta-analysis was conducted employing random-effects model.
resultsSixty-six trials with a total of 20,043 pediatric patients were included. Propofol had the highest incidence of apnea (39%) and ketamine had the lowest (14%). The combined incidence of apnea was 19% (95% CI: 15–23%). 36% of patients (95% CI: 31–41%) had hypoxia; the highest rates were seen with etomidate (83%) and dexmedetomidine (56%), while the lowest rates were seen with nitrous oxide (9%), and chloral hydrate (11%). 40% of instances had agitation, which was most common with regimens based on midazolam. Among the secondary adverse events were nausea (44%) and vomiting (55%). Higher rates of apnea and hypoxia were noted in children above the age of 3.
conclusionWhile nitrous oxide and chloral hydrate showed better safety profiles, propofol was linked to the highest risk of respiratory complications. These results highlight the significance of further research to improve sedation protocols and support the necessity of agent-specific, patient-centered sedation techniques in pediatric emergency care.
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