title: The clinical effect of fentanyl in comparison with ketamine in analgesic effect for oncology procedures in children: a randomized, double-blinded, crossover trial.
abstract: BACKGROUND
  Children often require relief of pain and anxiety when undergoing painful procedures.
  
  
  OBJECTIVE
  To determine the differences by comparing fentanyl and ketamine used in cancer-diagnosed children undergoing painful procedures.
  
  
  METHODS
  A randomized, double-blinded, crossover trial was conducted with 55 children undergoing painful procedures (intrathecal chemotherapy and/or bone marrow aspiration/biopsy). Patients were randomly assigned in a double-blinded fashion to receive either intravenous fentanyl or ketamine at 1 mcg/kg/dose and 1 mg/kg/dose, respectively. The result in effectiveness of the drug was measured using three parameters, 1) satisfaction score ranging from 0 to 10, 2) perception of procedural pain using FLACC scale, Wong-Baker FACES Pain Rating Scale and Visual Analog Scale, and 3) the frequency of vomiting nausea score.
  
  
  RESULTS
  The satisfaction amongpatients receiving fentanyl was significantly greater than ketamine (p = 0.007). In addition, both painful and nausea/vomiting were significantly decreased in the patients receiving fentanyl (p = 0.002 and p < 0.001, respectively). No serious complications were observed
  
  
  CONCLUSIONS
  This study demonstrated that intravenous fentanyl generated a superior clinical effect in satisfaction, decreased pain and nausea/vomiting, and showed no significant side-effects over ketamine. Fentanyl may also be recommended as a reasonable option before undergoing oncology procedures in children with cancer.
authors.forename: Chalinee
authors.initials: C
authors.lastname: Monsereenusorn
authors.forename: Piya
authors.initials: P
authors.lastname: Rujkijyanont
authors.forename: Chanchai
authors.initials: C
authors.lastname: Traivaree
mesh_terms: D000293:Adolescent; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009369:Neoplasms / Q000628:therapy; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D007649:Ketamine; D005283:Fentanyl