Continuous pentobarbital infusion in children is associated with high rates of complications

J Crit Care. 2004 Sep;19(3):174-8. doi: 10.1016/j.jcrc.2004.07.008.


Purpose: To evaluate the incidence and severity of complications related to continuous pentobarbital (PB) infusion for sedation in the Pediatric Intensive Care Unit (PICU).

Materials and methods: We conducted a retrospective, chart review study. All patients admitted to the PICU from January 1997 through June 1998 who received continuous IV PB infusion for sedation (n = 8) were included.

Results: All patients were intubated and mechanically ventilated prior to PB infusion. PB was used only as a second line sedative after a combination of an opioid and benzodiazepine failed to achieve adequate sedation. After initiation of PB, we were able to decrease or discontinue benzodiazepines and/or opioid doses and discontinue neuromuscular blocking drugs in all patients. We observed a high incidence of complications (62.5%) related to PB or the phenobarbital treatment used for barbiturate weaning, including blood pressure instability (25%), oversedation (12.5%), drug reaction (12.5%) and neurologic sequelae (12.5%). Discontinuation of the drug was required in 25% of the cases.

Conclusions: We found continuous PB infusion to be an effective sedative for children when other drugs fail. However, we observed a high rate of clinically significant complications requiring discontinuation of the drug.

MeSH terms

  • Child
  • Child, Preschool
  • Conscious Sedation
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / adverse effects*
  • Infant
  • Infusions, Intravenous
  • Intensive Care Units, Pediatric / statistics & numerical data*
  • Male
  • Pentobarbital / administration & dosage
  • Pentobarbital / adverse effects*
  • Retrospective Studies


  • Hypnotics and Sedatives
  • Pentobarbital