Pediatrics
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To determine the depth of sedation required for bone marrow aspiration and intrathecal injection of chemotherapeutic agents in children using a bispectral (BIS) index monitor and clinical assessment by an independent observer. ⋯ Children who undergo conscious sedation with propofol for intrathecal chemotherapy and bone marrow aspiration demonstrate BIS values and clinical assessments consistent with deep sedation. Because of an increased risk of adverse events when children undergo deep sedation, appropriate parental informed consent, age-appropriate resuscitative equipment, and skilled anesthesia personnel should be present for rescue in the event of cardiovascular and respiratory complications from deep sedation.
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Black widow spider envenomation (BWSE) is commonly associated with severe abdominal pain, muscle cramping, and hypertension. Treatment is primarily symptomatic with the use of opiates and benzodiazepines. Priapism is a complication of BWSE that has only rarely been reported. ⋯ Complete detumescence followed within several hours. The patient required no additional opiates for pain and was discharged from the hospital the following day. The patient's rapid improvement after antivenin suggests its efficacy in treating BWSE-associated priapism.