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Allen A. Mitchell, MD; Carol Louik, MSc; Peter Lacouture; Dennis Slone, MD; Peter Goldman, MD; Samuel Shapiro, MB, FRCP(E)

JAMA. 1982;247(17):2385-2388.

Abstract
We observed serious adverse reactions after premedication for computed tomographic (CT) head scans and therefore determined rates and risk factors for such reactions among 106 hospitalized children monitored by an intensive drug surveillance program. Reactions occurred in 13 patients (13%), including four cases of life-threatening cardiorespiratory depression or arrest after narcotic premedication. Other reactions included CNS depression, behavior changes, voiding problems, and vomiting. The risk of reaction was elevated in subjects who received high doses of a premedication drug (relative risk, 5.2) and in those who received four or more premedication drugs (relative risk, 3.7). All life-threatening reactions occurred among infants younger than 3 months, and two of these followed medication with only morphine sulfate, in the recommended dose. Risks of adverse reactions from premedication should be considered by physicians who order CT scans for hospitalized children.

(JAMA 1982;247:2385-2388)

Author Affiliations
From the Clinical Pharmacology Unit, Children's Hospital Medical Center, Harvard Medical School, Boston (Drs Mitchell and Goldman, Ms Louik, and Mr Lacouture), and the Drug Epidemiology Unit, School of Public Health, Boston University School of Medicine, Cambridge, Mass (Drs Mitchell, Slone, and Shapiro and Ms Louik).

Footnotes
Presented in part at the Society for Pediatric Research, San Francisco, April 27, 1981.

Reprint requests to the Pediatric Drug Surveillance Program, Children's Hospital Medical Center, 300 Longwood Ave, Boston, MA 02115 (Dr Mitchell).

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