[Intravenous midazolam-ketamine anaesthesia for closed reduction of forearm fractures in children: impact of additional axillary plexus anaesthesia].
BACKGROUND
The aim of this study was to compare ketamine requirements in children undergoing closed reduction of forearm fractures under midazolam-ketamine anaesthesia with or without axillary plexus anaesthesia.


METHODS
With hospital ethical committee approval, we retrospectively analyzed the records of children who received midazolam-ketamine anaesthesia in the years 2000-2001 (group A) and midazolam-ketamine anaesthesia combined with axillary plexus anaesthesia in the years 2002-2004 (group B) for closed reduction of forearm fractures. Requirements for ketamine and postoperative analgesics were noted. Groups were compared with the Mann-Whitney U-test or T-test and the chi2-test (p<0.05).


RESULTS
A total of 455 children (group A 225/group B 230) were included in this study. The total amounts of ketamine were not statistically different between the two groups (p=0.154). However, ketamine requirements became less if the time interval between start of axillary plexus anaesthesia and start of intervention became more than 15 min (p<0.05). Patients in group B requested fewer analgesics in the postoperative period (p<0.01).


CONCLUSIONS
In the clinical routine of an emergency department the combination of midazolam-ketamine anaesthesia with axillary plexus anesthesia for closed reduction of forearm fractures in children did not result in lower requirements of ketamine.
Wissler
M
M
Anästhesieabteilung, Universitäts-Kinderkliniken, Steinwiesstrasse 75, 8032, Zürich, Switzerland.
Tomaske
M
M
Stutz
K
K
Schmitz
A
A
Gerber
A
A
Weiss
M
M
D000293:Adolescent; D000771:Anesthesia, Intravenous; D000778:Anesthetics, Dissociative; D001917:Brachial Plexus; D002648:Child; D002675:Child, Preschool; D005260:Female; D005543:Forearm Injuries / Q000628:therapy*; D050723:Fractures, Bone / Q000628:therapy*; D006801:Humans; D006993:Hypnotics and Sedatives; D007223:Infant; D007649:Ketamine; D008297:Male; D008874:Midazolam; D009407:Nerve Block; D012189:Retrospective Studies
D000778:Anesthetics, Dissociative; D006993:Hypnotics and Sedatives; D007649:Ketamine; D008874:Midazolam