Effect of Ketamine-Sufentanil and Ketamine-Midazolam to Induce Sedation and Analgesia in Pediatric with Lumbar Puncture or Bone Marrow Aspiration

Abstract

Background: The combination of sedative and analgesic drugs has a favorable effect on pain management and sedation during painful procedures in pediatrics. Therefore, our aim was to compare the effect of sedation and analgesia of ketamine-sufentanil and ketamine-midazolam in painful procedures in children with blood malignancies. Methods: This double-blind, clinical trial was performed on 82 children with malignancy who had indication of painful diagnostic intervention; patients were randomly divided into two groups of ketamine-sufentanil (KS) and ketamine -midazolam (KM). In KS group, sufentanil 0.5mcg/ kg and ketamine 1mg/ kg and in the KM group, ketamine 1mg/ kg, and midazolam 0.1mg/ kg bolus were prescribed. In either group, hemodynamic indicators of sedation, side effects, duration of effectiveness were recorded. Data were analyzed using SPSS 20. Results: Sedation based on Ramsay sedation score was not significantly different between the two groups (p= 0.39). The average recovery time in the midazolam-ketamine group was higher (p-value= 0.076). Conclusion: The combination of ketamine-sufentanil and ketamine-midazolam was effective in sedation and analgesia in bone marrow aspiration and lumber puncture; side effects were however, lower in ketamine-midazolam group.

Keywords

• ketamine
• sufentanil
• midazolam
• pediatric