title: A Pilot Study of Ketamine versus Midazolam/Fentanyl Sedation in Children Undergoing GI Endoscopy.
abstract: Background. Ketamine sedation has been found superior by physician report to traditional sedation regimens for pediatric endoscopy. Goal. To objectively compare sedation with ketamine versus midazolam/fentanyl for children undergoing gastrointestinal endoscopy. Study. Patients received one of two regimens and were independently monitored using a standardized rating scale. Results. There were 2 episodes of laryngospasm during ketamine sedation. Univariate analyses showed patients sedated with ketamine (n = 17) moved more (median 25% of procedure time versus 8%, P = .03) and required similar low levels of restraint (0.83% versus 0.25%, P = .4) as patients sedated with midazolam/fentanyl (n = 20). Age-adjusted analyses suggested that patients sedated with ketamine were comparably more quiet (P = .002). Conclusions. A pilot trial of ketamine at our institution was associated with episodes of laryngospasm. In addition, children sedated with ketamine moved and required restraint similarly to patients sedated with midazolam/fentanyl. Physician perceptions may be affected by the fact that children who received ketamine were less likely to vocalize distress.
authors.affiliation: Division of Gastroenterology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: Jenifer R
authors.initials: JR
authors.lastname: Lightdale
authors.forename: Paul D
authors.initials: PD
authors.lastname: Mitchell
authors.forename: Meghan E
authors.initials: ME
authors.lastname: Fredette
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Mahoney
authors.forename: Steven E
authors.initials: SE
authors.lastname: Zgleszewski
authors.forename: Lisa
authors.initials: L
authors.lastname: Scharff
authors.forename: Victor L
authors.initials: VL
authors.lastname: Fox