The Efficacy and Safety of Procedural Sedoanalgesia with Midazolam and Ketamine in Pediatric Hematology.
OBJECTIVE
The aim of this study is to investigate the efficacy and safety of sedoanalgesia performed outside the operating room by pediatricians trained in advanced airway management and life support.


METHODS
Midazolam and ketamine were administered consecutively by intravenous route under cardiorespiratory monitoring for painful procedures of pediatric hematology.


RESULTS
A total of 115 patients had 237 sedoanalgesia sessions. Sedation time was 24.02±23.37 s and sedation success was 92.5% (Ramsay scores of ≥5). Patient satisfaction was high. The recovery time was 28.81±14.4 min. Although statistically significant (p<0.01) increases in systolic and diastolic blood pressure, heart rate, and respiratory rate were observed without clinical importance, they improved without any intervention. No severe adverse events were observed.


CONCLUSIONS
Sedoanalgesia with intravenous midazolam and ketamine for pediatric hematology and oncology patients' painful minor invasive procedures performed in an optimally equipped setting outside the operating room by pediatricians trained and certificated in advanced airway management and life support is effective and safe.
Kocaeli University Faculty of Medicine Hospital, Department of Pediatrics, Division of Pediatric Hematology, Kocaeli, Turkey Phone: +90 532 596 25 54 E-mail: semaylan@hotmail.com.
Sema Aylan
SA
Gelen
Nazan
N
Sarper
Uğur
U
Demirsoy
Emine
E
Zengin
Esma
E
Çakmak
D000293:Adolescent; D000698:Analgesia / Q000009:adverse effects / Q000379:methods*; D000700:Analgesics / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001856:Bone Marrow Examination / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D054810:Deep Sedation / Q000009:adverse effects / Q000379:methods*; D004357:Drug Synergism; D006212:Hallucinations / Q000139:chemically induced; D006402:Hematologic Diseases / Q000628:therapy*; D006405:Hematology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D007223:Infant; D007278:Injections, Spinal / Q000009:adverse effects; D007649:Ketamine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D008874:Midazolam / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D010100:Oxygen / Q000097:blood; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010342:Patient Acceptance of Health Care; D010348:Patient Care Team; D010372:Pediatrics; D011446:Prospective Studies; D012798:Sialorrhea / Q000139:chemically induced; D014839:Vomiting / Q000139:chemically induced
D000700:Analgesics; D006993:Hypnotics and Sedatives; D007649:Ketamine; D008874:Midazolam; D010100:Oxygen