title: Sedation with intravenous benzodiazepine and ketamine for renal biopsies.
abstract: "Lytic cocktail" is the customary sedation before percutaneous renal biopsy. Owing to deficient sedation and respiratory depression, this approach is no longer advised. The intravenous combination of a benzodiazepine plus ketamine, which has been found to be effective and safe in several conditions, was therefore used for 60 pediatric biopsies. In addition to pulse oximetry, a physician trained in airway management monitored the patient. The quality of sedation was acceptable (n = 7) or optimal (n = 53) in all cases. None of the patients required ventilation or intubation. A mild oxygen desaturation lasting 4 min or less was detected in 6 patients. None of the patients experienced major change in respiratory rate or blood pressure. The administration of ketamine and, in some cases, the biopsy puncture were associated with a mildly increased heart rate. In conclusion, a benzodiazepine plus ketamine provides effective deep sedation for renal biopsy in childhood.
authors.affiliation: Department of Pediatrics, University of Bern, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Riavis
authors.forename: R
authors.initials: R
authors.lastname: Laux-End
authors.forename: M I
authors.initials: MI
authors.lastname: Carvajal-Busslinger
authors.forename: H
authors.initials: H
authors.lastname: Tschäppeler
authors.forename: M G
authors.initials: MG
authors.lastname: Bianchetti
mesh_terms: D000293:Adolescent; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous; D014151:Anti-Anxiety Agents; D001706:Biopsy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003975:Diazepam; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D007223:Infant; D007649:Ketamine; D007668:Kidney / Q000473:pathology*; D008297:Male
chemical_list: D018686:Anesthetics, Intravenous; D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D007649:Ketamine; D003975:Diazepam