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Original Article
Sedation with intravenous ketamine and midazolam for painful procedures in children
Article first published online: 5 APR 2006
DOI: 10.1111/j.1442-200X.2006.02186.x
Additional Information
How to Cite
KARAPINAR, B., YILMAZ, D., DEMIRAĞ, K. and KANTAR, M. (2006), Sedation with intravenous ketamine and midazolam for painful procedures in children. Pediatrics International, 48: 146–151. doi: 10.1111/j.1442-200X.2006.02186.x
Publication History
- Issue published online: 5 APR 2006
- Article first published online: 5 APR 2006
- Received 22 January 2004; accepted 31 May 2005.
- Abstract
- Article
- References
- Cited By
Keywords:
- analgesia;
- children;
- ketamine;
- midazolam;
- sedation
Abstract
Background: 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.
Methods: 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, assesment of the level of sedation, adverse events, and recovery time for each procedural sedation and analgesia.
Results: 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 = 4), and rash (n = 4). There were no adverse outcomes attributable to ketamine and midazolam combination.
Conclusion: Skilled pediatric intensivists can safely and effectively administer ketamine and midazolam to facilitate painful procedures outside the operating room setting.