Barbiturates

Sedation remains the most important, and sometimes the most difficult, part of diagnostic or therapeutic procedures in children. Today, computed tomography (CT) scan and magnetic resonance imaging (MRI) are widely used in the evaluation of pediatric disease; and the need for safe and effective sedation practice has grown. Pentobarbital, thiopental, and methohexital are 3 barbiturates that have gained popularity in the pediatric emergency department for sedation. Pentobarbital has been used with great success when sedation is required for nonpainful procedures in the emergency department setting. Thiopental was used in the early 1980s but lost popularity in the 1990s. Methohexital, because of its ultrashortacting properties, has gained popularity for use in painful (eg, fracture reduction, laceration repair) and nonpainful procedures (eg, CT scanning, MRI). In this article, each drug is discussed for routes of administration, side effects, contraindications, and overall success rates.