AIM:To evaluate the safety and effectiveness of intravenous ketamine-midazolam sedation during pediatric endoscopy in the Arab world.METHODS:A retrospective cohort study of all pediatric endoscopic procedures performe...AIM:To evaluate the safety and effectiveness of intravenous ketamine-midazolam sedation during pediatric endoscopy in the Arab world.METHODS:A retrospective cohort study of all pediatric endoscopic procedures performed between 2002-2008 at the shared endoscopy suite of King Abdullah University Hospital,Jordan University of Science & Technology,Jordan was conducted.All children were > 1 year old and weighed > 10 kg with American Society of Anesthesiologists class 1 or 2.Analysis was performed in terms of sedation-related complications(desaturation,respiratory distress,apnea,bradycar-dia,cardiac arrest,emergence reactions),adequacy of sedation,need for sedation reversal,or failure to complete the procedure.RESULTS:A total of 301 patients(including 160 males) with a mean age of 9.26 years(range,1-18 years) were included.All were premedicated with atropine;and 79.4%(239/301) had effective and uneventful sedation.And 248(82.4%) of the 301 patients received a mean dose of 0.16 mg/kg(range,0.07-0.39) midazolam and 1.06 mg/kg(range,0.31-2.67) ketamine,respectively within the recommended dosage guidelines.Recommended maximum midazolam dose was exceeded in 17.6% patients [34 female(F):19 male(M),P = 0.003] and ketamine in 2.7%(3 M:5 F).Maximum midazolam dose was more likely to be exceeded than ketamine(P < 0.001).Desaturation occurred in 37(12.3%) patients,and was reversible by supplemental oxygen in all except 4 who continue to have desaturation despite supplemental oxygen.Four(1.3%) patients had respiratory distress and 6(2%) were difficult to sedate and required a 3rd sedative;12(4%) required reversal and 7(2.3%) failed to complete the procedure.None developed apnea,bradycardia,arrest,or emergence reactions.CONCLUSION:Ketamine-midazolam sedation appears safe and effective for diagnostic pediatric gastrointestinal endoscopy in the Arab world for children aged > 1 year and weighing > 10 kg without co-morbidities.展开更多
文摘AIM:To evaluate the safety and effectiveness of intravenous ketamine-midazolam sedation during pediatric endoscopy in the Arab world.METHODS:A retrospective cohort study of all pediatric endoscopic procedures performed between 2002-2008 at the shared endoscopy suite of King Abdullah University Hospital,Jordan University of Science & Technology,Jordan was conducted.All children were > 1 year old and weighed > 10 kg with American Society of Anesthesiologists class 1 or 2.Analysis was performed in terms of sedation-related complications(desaturation,respiratory distress,apnea,bradycar-dia,cardiac arrest,emergence reactions),adequacy of sedation,need for sedation reversal,or failure to complete the procedure.RESULTS:A total of 301 patients(including 160 males) with a mean age of 9.26 years(range,1-18 years) were included.All were premedicated with atropine;and 79.4%(239/301) had effective and uneventful sedation.And 248(82.4%) of the 301 patients received a mean dose of 0.16 mg/kg(range,0.07-0.39) midazolam and 1.06 mg/kg(range,0.31-2.67) ketamine,respectively within the recommended dosage guidelines.Recommended maximum midazolam dose was exceeded in 17.6% patients [34 female(F):19 male(M),P = 0.003] and ketamine in 2.7%(3 M:5 F).Maximum midazolam dose was more likely to be exceeded than ketamine(P < 0.001).Desaturation occurred in 37(12.3%) patients,and was reversible by supplemental oxygen in all except 4 who continue to have desaturation despite supplemental oxygen.Four(1.3%) patients had respiratory distress and 6(2%) were difficult to sedate and required a 3rd sedative;12(4%) required reversal and 7(2.3%) failed to complete the procedure.None developed apnea,bradycardia,arrest,or emergence reactions.CONCLUSION:Ketamine-midazolam sedation appears safe and effective for diagnostic pediatric gastrointestinal endoscopy in the Arab world for children aged > 1 year and weighing > 10 kg without co-morbidities.
