Promethazine hydrochloride reduces children’s agitation during ocular examination for trauma
https://doi.org/10.4081/ejtm.2022.10808
Accepted: 26 August 2022
HTML: 26
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Examination and intervention are always the causes of agitation, anxiety, and fear in children’s lives. This study aimed to investigate the effectiveness of promethazine hydrochloride in reducing children’s agitation during the ocular examination for trauma. In this interventional-clinical trial study, a total of 62 children referred to Al-Zahra Ophthalmology Hospital in Zahedan, Iran, were evaluated in two matched groups (case (n = 31) and control (n = 31)) for an initial examination of ocular trauma. Finally, the intervention was performed (giving placebo or promethazine hydrochloride cough syrup 20 minutes before the initial ocular examination at 0.5 mg/kg), and the demographic information form and researcher-made questionnaire modeled on the Cohen-Mansfield Agitation Inventory (CMAI) were completed. The obtained results revealed that the mean scores of physical/aggressive behaviors (p ˂ 0.001), physical/nonaggressive behaviors (p = 0.013), verbal/aggressive behaviors (p ˂ 0.001), and hiding behaviors (p ˂ 0.001) were significantly lower in the promethazine hydrochloride-receiving group than the placebo group. These findings demonstrated that promethazine hydrochloride cough syrup facilitated the examination among the pediatric patients who suffered from traumatic ocular injuries. However, further studies in this field need to be carried out through randomized controlled trials.
Lerwick JL. Minimizing pediatric healthcare-induced anxiety and trauma. World J Clin Pediatr. 2016 May 8;5(2):143-50. DOI: https://doi.org/10.5409/wjcp.v5.i2.143
Peacock-Chambers E, Ivy K, Bair-Merritt M. Primary care interventions for early childhood development: a systematic review. Pediatrics. 2017 Dec;140(6):e20171661. DOI: https://doi.org/10.1542/peds.2017-1661
Rodriguez CM, Clough V, Gowda AS, Tucker MC. Multimethod assessment of children’s distress during noninvasive outpatient medical procedures: Child and parent attitudes and factors. J Pediatr Psychol. 2012 Jun;37(5):557-66. DOI: https://doi.org/10.1093/jpepsy/jss005
Pine DS, Cohen JA. Trauma in children and adolescents: Risk and treatment of psychiatric sequelae. Biol Psychiatry. 2002 Apr 1;51(7):519-31. DOI: https://doi.org/10.1016/S0006-3223(01)01352-X
Green BL, Korol M, Grace MC, Vary MG, Leonard AC, Gleser GC, Smitson-Cohen S. Children and disaster: Age, gender, and parental effects on PTSD symptoms. J Am Acad Child Adolesc Psychiatry. 1991 Nov;30(6):945-51. DOI: https://doi.org/10.1097/00004583-199111000-00012
Gan X, Lin H, Chen J, Lin Z, Lin Y, Chen W. Rescue sedation with intranasal dexmedetomidine for pediatric ophthalmic examination after chloral hydrate failure: a randomized, controlled trial. Clin Ther. 2016 Jun;38(6):1522-1529. DOI: https://doi.org/10.1016/j.clinthera.2016.04.036
Tavassoli-Hojjati S, Mehran M, Haghgoo R, Tohid-Rahbari M, Ahmadi R. Comparison of oral and buccal midazolam for pediatric dental sedation: a randomized, cross-over, clinical trial for efficacy, acceptance and safety. Iran J Pediatr. 2014 Apr;24(2):198-206.
Golpayegani MV, Dehghan F, Ansari G, Shayeghi S. Comparison of oral Midazolam-Ketamine and Midazolam-Promethazine as sedative agents in pediatric dentistry. Dent Res J (Isfahan). 2012 Jan;9(1):36-40. DOI: https://doi.org/10.4103/1735-3327.92925
Harris PD, Farmery AD, Patel CK. The challenges of positioning an infant undergoing optical coherence tomography under general anesthesia. Paediatr Anaesth. 2009 Jan;19(1):64-5. DOI: https://doi.org/10.1111/j.1460-9592.2008.02688.x
Oberacher-Velten I, Prasser C, Rochon J, Ittner KP, Helbig H, Lorenz B. The effects of midazolam on intraocular pressure in children during examination under sedation. Br J Ophthalmol. 2011 Aug;95(8):1102-5. DOI: https://doi.org/10.1136/bjo.2009.173641
American Academy of Pediatric Dentistry. Guideline on use of nitrous oxide for pediatric dental patients. Pediatr Dent. 2013 Sep-Oct;35(5):E174-8.
Singh N, Pandey R, Saksena A, Jaiswal J. A comparative evaluation of oral midazolam with other sedatives as premedication in pediatric dentistry. J Clin Pediatr Dent. 2002 Winter;26(2):161-4. DOI: https://doi.org/10.17796/jcpd.26.2.j714x4795474mr2p
El Hay OA, Abo El Enin MA, Hamada MH, Ahmed AM. A comparative study between midazolam, promethazine, and chloral hydrate as oral premedication in pediatric patients. Ain-Shams J Anaesthesiol 2015;8(1):56-63. DOI: https://doi.org/10.4103/1687-7934.153939
Bui T, Redden RJ, Murphy S. A comparison study between ketamine and ketamine-promethazine combination for oral sedation in pediatric dental patients. Anesth Prog. 2002 Winter;49(1):14-8.
Mathai A, Nazareth M, Raju RS. Preanesthetic sedation of preschool children: comparison of intranasal midazolam versus oral promethazine. Anesth Essays Res. 2011 Jan-Jun;5(1):67-71. DOI: https://doi.org/10.4103/0259-1162.84197
Rabinowitz J, Davidson M, De Deyn PP, Katz I, Brodaty H, Cohen-Mansfield J. Factor analysis of the Cohen-Mansfield Agitation Inventory in three large samples of nursing home patients with dementia and behavioral disturbance. Am J Geriatr Psychiatry. 2005 Nov;13(11):991-8. DOI: https://doi.org/10.1097/00019442-200511000-00010
Cantisani C, Ricci S, Grieco T, Paolino G, Faina V, Silvestri E, Calvieri S. Topical promethazine side effects: our experience and review of the literature. Biomed Res Int. 2013;2013:151509. DOI: https://doi.org/10.1155/2013/151509
Barzegari H, Zohrevandi B, Masoumi K, Forouzan A, Darian AA, Khosravi S. Comparison of oral midazolam and promethazine with oral midazolam alone for sedating children during computed tomography. Emerg (Tehran). 2015 Summer;3(3):109-13.
Pajntar M, Valentincic B, Verdenik I. The effect of pethidine hydrochloride on the cervical muscles in the active phase of labour. Clin Exp Obstet Gynecol. 1993;20(3):145-50.
Sakaguchi T, Ohkawara B, Kishimoto Y, Miyamoto K, Ishizuka S, Hiraiwa H, Ishiguro N, Imagama S, Ohno K. Promethazine Downregulates Wnt/β-Catenin Signaling and Increases the Biomechanical Forces of the Injured Achilles Tendon in the Early Stage of Healing. Am J Sports Med. 2022 Apr;50(5):1317-1327. DOI: https://doi.org/10.1177/03635465221077116
Burnett HF, Lambley R, West SK, Ungar WJ, Mireskandari K. Cost-effectiveness analysis of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures. Br J Ophthalmol. 2015 Nov;99(11):1565-70. DOI: https://doi.org/10.1136/bjophthalmol-2015-306604
Pao M, Bosk A. Anxiety in medically ill children/adolescents. Depress Anxiety. 2011 Jan;28(1):40-9. DOI: https://doi.org/10.1002/da.20727
Ansari G, Razavi S, Toomarian L, Eghbali A, Shayeghi S. Oral Midazolam Vs Promethazine as Pre Sedation Medication in Pediatric Dentistry. J Dent Sch 2018;36(2):47-50.
Copyright (c) 2022 The Authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
