Comparing Ketamine and Midazolam/Fentanyl for Children's Endoscopy
Author Information
Author(s): Jenifer R. Lightdale, Paul D. Mitchell, Meghan E. Fredette, Lisa B. Mahoney, Steven E. Zgleszewski, Lisa Scharff, Victor L. Fox
Primary Institution: Children's Hospital Boston
Hypothesis
Patients receiving ketamine would move less, vocalize distress less, and require less restraint during GI procedures than patients receiving standard sedation with midazolam and fentanyl.
Conclusion
Ketamine sedation was associated with episodes of laryngospasm and similar levels of movement and restraint compared to midazolam/fentanyl sedation.
Supporting Evidence
- Patients sedated with ketamine moved more than those sedated with midazolam/fentanyl.
- There were two episodes of laryngospasm during ketamine sedation.
- Ketamine sedation was associated with less vocalization of distress compared to midazolam/fentanyl.
Takeaway
This study looked at how well ketamine works for calming kids during endoscopy compared to another medicine. It found that while kids on ketamine were less likely to show they were upset, they still moved around a lot.
Methodology
A prospective study comparing ketamine and midazolam/fentanyl sedation in children undergoing endoscopy, with independent monitoring using a standardized rating scale.
Potential Biases
Selection bias due to physician judgment in choosing sedation type.
Limitations
The study was not randomized, had small sample sizes, and unequal patient characteristics between groups.
Participant Demographics
Median age of ketamine group was 5 years, while midazolam/fentanyl group was 12.5 years; 76% of ketamine group were male.
Statistical Information
P-Value
0.03
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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