Sedation with intravenous ketamine and midazolam for painful procedures in children

Pediatrics International : Official Journal of the Japan Pediatric Society
Bülent KarapinarMehmet Kantar

Abstract

Children often require relief of pain and anxiety when undergoing painful procedures. The purpose of this study is to evaluate the effectiveness and safety of painful pediatric procedures performed by pediatric intensivist, using the combination of intravenous ketamine and midazolam for sedation and analgesia. The records of the patients who received intravenous ketamine-midazolam combination for painful procedures in the pediatric sedation unit of a university hospital over a 3 year period were retrospectively reviewed to determine indications, dosing, assessment of the level of sedation, adverse events, and recovery time for each procedural sedation and analgesia. A total of 227 children aged 4 months to 18 years were admitted to the pediatric sedation unit for a total of 356 procedures. The indications for procedural sedation and analgesia included bone marrow aspiration or biopsy (50.8%), central venous catheter insertion (27%), and others (22%). A total of 46 adverse events (12.9%) were observed. These adverse events included SpO2 below 85% without apnea (n = 14), apnea (n = 3), transient stridor (n = 2), hypertension and tachycardia (n = 8), hypersalivation (n = 6), vomiting (n = 5), hallucinatory emergence reaction (n = ...Continue Reading

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Citations

Oct 23, 2014·International Journal of Critical Illness and Injury Science·Mehdi MomeniJeyran Zebardast
Dec 7, 2010·The American Journal of Emergency Medicine·Tara Cassidy-SmithBrigitte M Baumann
Mar 14, 2007·Journal of Pain and Symptom Management·Charles F von Gunten, Matthew Soskins
Jun 23, 2016·Saudi Pharmaceutical Journal : SPJ : the Official Publication of the Saudi Pharmaceutical Society·Giath GazalKhalid H Al-Samadani
Dec 15, 2017·Journal of Pediatric Hematology/oncology·Shunsuke NakagawaYoshifumi Kawano
Dec 3, 2017·Wiener medizinische Wochenschrift·Harald SauerJuergen Foell
May 1, 2009·Pediatric Emergency Care·Elliot Melendez, Richard Bachur

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