Ketamine With and Without Midazolam for Gastrointestinal Endoscopies in Children

Brecelj, Jernej; Trop, Tina Kamhi; Orel, Rok

doi:10.1097/mpg.0b013e31824504af

Cited by 29 publications

(24 citation statements)

References 26 publications

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“…These studies showed that ketamine plus midazolam is more effective and has fewer side effects than ketamine alone 2,3,11. In our previous study, we used 0.1 mg/kg midazolam and a 0.5 mg/kg low dose of ketamine in UGE for children; the success rate was 97.42% 24.…”

Section: Discussionmentioning

confidence: 97%

“…In our previous study, we used 0.1 mg/kg midazolam and a 0.5 mg/kg low dose of ketamine in UGE for children; the success rate was 97.42% 24. Brecelj et al 11 reported that the initial dose of ketamine should be 1–1.5 mg/kg and its efficacy is not sufficient at lower doses. In the present study, we used 1.03 mg/kg ketamine, on average, and achieved 100% success, which supports their view.…”

Section: Discussionmentioning

confidence: 99%

“…Hallucinations, agitation and emergence reactions were evaluated and recorded. Emergence reactions included severe agitations such as nightmares, hallucinations and delirium observed during the recovery time 11.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, there may be some effects called emergence reactions such as nightmares, delirium, excitation and physical aggression 8. Ketamine is used in combination with benzodiazepines (especially midazolam) to reduce the frequency of these side effects 2,3,9–11. Midazolam is a very short-acting benzodiazepine.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of sedation with midazolam–ketamine versus propofol–fentanyl during endoscopy in children: a randomized trial

Akbulut¹,

Saylan²,

Sengu³

et al. 2017

European Journal of Gastroenterology &Amp; Hepatology

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PurposeWe aimed to compare the efficacy and safety of midazolam plus ketamine versus fentanyl plus propofol combination administered to children undergoing upper gastrointestinal endoscopy (UGE) and to determine the most appropriate sedation protocol.Materials and methodsThis prospective, randomized, single-blind study included patients between the ages of 4 and 17 years who underwent UGE for diagnostic purposes. Patients were divided randomly into groups A (midazolam–ketamine combination, n=119) and B (fentanyl plus propofol combination, n=119). The effectiveness of the sedation and complications during the procedure and recovery period were recorded.ResultsThe processes started without an additional dose of the drug for 118 patients (99.1%) in group A and for 101 patients (84.8%) in group B (P=0.001). The average dose of ketamine administered to the patients in group A was 1.03±0.15 mg/kg and the average dose of propofol administered to the patients in group B was 1.46±0.55 mg/kg. None of the patients stopped the endoscopic procedure in group A, but one patient (0.8%) had to discontinue the endoscopic procedure in group B. 27 patients in group A (22.7%) and 41 patients (34.5%) in group B developed complications during the procedure (P=0.044). The rate of complications during the recovery of group A (110 patients, 92.4%) was significantly higher than that in group B (48 patients, 40.3%) (P=0.001).ConclusionIn children, UGE procedures can be quite comfortable when using the midazolam–ketamine combination. However, adverse effects related to ketamine were observed during recovery.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A comparison of sedation with midazolam–ketamine versus propofol–fentanyl during endoscopy in children: a randomized trial

Akbulut¹,

Saylan²,

Sengu³

et al. 2017

European Journal of Gastroenterology &Amp; Hepatology

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“…In another study, there was no difference between ketamine group and ketamine-midazolam group regarding vomiting, and vomiting was observed totally in 17% of cases [20]. …”

Section: Discussionmentioning

confidence: 99%

Investigation of Efficacy of Lidocaine Spray for Sedated Esophagogastroduodenoscopy in Children

Baştürk

Artan

Yılmaz

2017

Pediatr Gastroenterol Hepatol Nutr

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PurposeOur aim in this study is to investigate efficacy of topical lidocaine spray for sedated esophagogastroduodenoscopy (EGD) in children.MethodsThe endoscopy of children aged between 3-18 years who underwent EGD in our endoscopy unit. Intravenous (IV) midazolam and ketamine were used for sedation. Prior to sedation, endoscopy nurse applied topical lidocaine 10% with pump spray at 1 mg/kg dose in group 1, and distilled water via identically scaled pump spray in group 2, in a double blinded fashion.ResultsSedation was not applied in 24.1% of the cases in topical lidocaine spray group (LS group) and in 5.7% of the cases in distilled water spray group (DS group). Gag reflex was observed in 6.5% of cases in LS group and 33.3% of cases in DS group (p=0.024), increased oral secretion was observed in 9.3% of cases in LS group and 51.7% of cases in DS group (p=0.038), sore throat was observed in 3.7% of cases in LS group and 35.6% of cases in DS group (p=0.019) and the difference was statistically significant.ConclusionThe study showed that topical pharyngeal lidocaine reduces both requirement and amount of IV sedation before EGD in children and sore throat, gag reflex and decreased oral secretion increase.

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General Approach to Endoscopy: Sedation, Monitoring, and Preparation

Fatima

Rex

2015

Yamada' S Textbook of Gastroenterology

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Ketamine With and Without Midazolam for Gastrointestinal Endoscopies in Children

Cited by 29 publications

References 26 publications

A comparison of sedation with midazolam–ketamine versus propofol–fentanyl during endoscopy in children: a randomized trial

A comparison of sedation with midazolam–ketamine versus propofol–fentanyl during endoscopy in children: a randomized trial

Investigation of Efficacy of Lidocaine Spray for Sedated Esophagogastroduodenoscopy in Children

General Approach to Endoscopy: Sedation, Monitoring, and Preparation

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