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.