title: Safety and effectiveness of ketamine as a sedative agent for pediatric GI endoscopy.
abstract: BACKGROUND
  The ideal sedation for children undergoing GI endoscopy remains elusive. After ketamine was introduced as a sedative agent in our GI procedure suite, improved sedation and reduced complications were observed. The aim of this study was to assess the safety and effectiveness of ketamine as a sedative agent for GI endoscopy in pediatric patients.
  
  
  METHODS
  A retrospective cohort study of 402 procedures (EGD, colonoscopy) was performed. Sedation-related complications were defined as hypoxia (oxygen saturation <95% by pulse oximetry), agitation, emergence reactions, stridor, laryngospasm, nausea, vomiting, aspiration, and muscle twitching, or any combination thereof. Sedation groups were defined as the following: Group I, midazolam and meperidine (n=192); Group II, midazolam, meperidine, and ketamine (n=82); and Group III, midazolam and ketamine (n=128).
  
  
  RESULTS
  Group 1 (midazolam and meperidine) had the highest frequency of complications, most commonly hypoxia. Group 3 (midazolam and ketamine) had the lowest rate of complications (p=0.001) and the highest rate of adequate sedation, although the difference was not significant (p=0.07).
  
  
  CONCLUSIONS
  The combination of midazolam and ketamine appears to provide safe and effective sedation for pediatric patients undergoing endoscopy.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030-2399, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Gilger
authors.forename: Renee S
authors.initials: RS
authors.lastname: Spearman
authors.forename: Craig L
authors.initials: CL
authors.lastname: Dietrich
authors.forename: Glen
authors.initials: G
authors.lastname: Spearman
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wilsey
authors.forename: Mayssa N
authors.initials: MN
authors.lastname: Zayat
mesh_terms: D002648:Child; D016292:Procedural Sedation; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007649:Ketamine / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008614:Meperidine / Q000008:administration & dosage; D008874:Midazolam / Q000008:administration & dosage
chemical_list: D006993:Hypnotics and Sedatives; D007649:Ketamine; D008614:Meperidine; D008874:Midazolam