title: The factors of ketamine that affect sedation in children with oncology procedures: parent satisfaction perspective.
abstract: BACKGROUND
  The pain and its complication during sedation with ketamine remain a significant problem for children with hematologic malignancy.
  
  
  OBJECTIVE
  The purpose of the present study was to evaluate further the parental satisfaction for procedural sedation and analgesia during pediatric hematology/oncology procedures perfonned by pediatrician in the Department of Pediatrics, Phramongkutklao Hospital.
  
  
  METHODS
  The authors prospectively evaluated our experience using intravenous ketamine 1 mg/kg for oncology patients undergoing procedures at Department ofPediatrics, Phramongkutklao Hospital. The procedure was assessed by way ofaphysician-completed form and by evaluation of questionnaires given to parents to estimate levels of pain by using a 0 to 10 mm visual analog scale (VAS) at 2 hours after procedures and results in any adverse events with respect to age, gende, procedures performed, ketamine dosage and recovery time.
  
  
  RESULTS
  Total of46 children aged 6 months to 15 years with 46procedures were observed at pediatric unit post-procedure. The indicationsfor procedural sedation and analgesia included lumbar puncture and intrathecal chemotherapy (50%), bone marrow aspiration or biopsy (21.7%), and both plrocedures (28.3%). The median VAS scale during oncology procedures was 3, which were expressed by all the parents/guardians of the children treated. Adverse effects were observed in all children including nausea (30.4%), hypersalivation (26.1%), vomiting (21.7%), hallucinlation (4.2%). No child required admission to hospital and there were no serious complications.
  
  
  CONCLUSIONS
  hntravenous ketamine 1 mg/kg is effective for invasive procedures in children with malignancy. The use of intravenous ketamine may produce psychedelic effects in children. These adverse effects may alter the child's comfort and parental satisfaction especially in the young children.
authors.forename: Chanchai
authors.initials: C
authors.lastname: Traivaree
authors.forename: Wanchana
authors.initials: W
authors.lastname: Jindakam
authors.forename: Chalinee
authors.initials: C
authors.lastname: Monsereenusorn
authors.forename: Piya
authors.initials: P
authors.lastname: Rujkijyanont
authors.forename: Rachata
authors.initials: R
authors.lastname: Lumkul
mesh_terms: D000293:Adolescent; D000762:Anesthesia Recovery Period; D000778:Anesthetics, Dissociative / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D019337:Hematologic Neoplasms; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D007649:Ketamine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control; D010290:Parents; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale
chemical_list: D000778:Anesthetics, Dissociative; D007649:Ketamine