Procedural sedation in children for magnetic resonance imaging--comparison between ketamine diazepam combination with midazolam fentanyl combination.
A deeper level of sedation by an anaesthesiologist is requirement for magnetic resonance imaging (MRI) in paediatric populations and sedation of children is different from sedation of adults. The purpose of the study was to compare the efficacy, safety, tolerability and cost effectiveness of ketamine, diazepam combination to midazolam, fentanyl combination for sedation of children during MRI. One hundred twenty children of both sex, age between 1-10 years, American Society of Anesthesiologist (ASA) physical status I and II were distributed into two groups. Group A (n=60) were sedated with 1.5 mg/kg body weight ketamine and 0.1 mg/kg body weight diazepam intravenously. Group B (n=60) were sedated with midazolam 0.05 mg/kg bodyweight and fentanyl 1 microg/kg body weight intravenously. Both groups showed satisfactory sedating condition for MRI. Incidences of side effects of drug regimens during sedation and recovery were recorded in both groups; those were transient and minor inconveniences. Pulse, blood pressure and respiration were within normal range in both groups. Mean procedure time was almost same in both groups and mean recovery time was more in group A than group B and the difference was statistically significant (p<0.05). Every child of both groups was discharged to home. Sedation regimen of group B found 5 times more costly than group A. Both the regimens were found safe and effective for paediatric sedation during MRI but ketamine, diazepam combination found more cost effective which, is a considerable matter in Bangladesh.
Maruf
A A
AA
Department of Anaesthesia and Intensive Care, CMH, Dhaka, Bangladesh.
Hossain
M D
MD
Ahmed
M
M
Samsad
I A
IA
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000191:economics; D000778:Anesthetics, Dissociative / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D054810:Deep Sedation; D003975:Diazepam / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007223:Infant; D007649:Ketamine / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*
D000759:Adjuvants, Anesthesia; D000778:Anesthetics, Dissociative; D006993:Hypnotics and Sedatives; D007649:Ketamine; D003975:Diazepam; D008874:Midazolam; D005283:Fentanyl