Abstract | BACKGROUND: Children often require relief of pain and anxiety while undergoing diagnostic and therapeutic procedures. Procedural sedation and analgesia (PSA) is the safe and effective control of pain, anxiety and motion so as to allow a necessary procedure to be performed and to provide an appropriate degree of memory loss or decreased awareness. OBJECTIVE: To prospectively describe procedural sedation and analgesia as performed in the pediatric oncology unit and to report the success of sedation and the incidence of complications. METHODS: IV Midazolam and IV Ketamine were used for PSA in pediatric oncology patients undergoing painful procedures. RESULTS: Between June 2004 and December 2004, 55 diagnostic and therapeutic procedures were performed using PSA in 16 children. There were 9 boys and 7 girls with a median age of 11 years. Twelve patients had hematolymphoid malignancies and 4 patients had solid tumors. The indication for PSA were bone marrow aspiration and or biopsy in 7 patients, therapeutic lumbar puncture in 43 patients, bone marrow aspiration and lumbar puncture in 4 patients and skin biopsy in 1 patient. All 55 procedures were successfully completed. Adverse events occurred in 15 (27%) episodes and included transient drop in oxygen saturation, vomiting, dizziness and disinhibition with crying spells. Average time to arousable state and full recovery was 22 minutes and 31 minutes respectively. None of the patients complained of post procedure pain nor recalled the procedure at the follow up visit. CONCLUSION: Procedural sedation and analgesia using midazolam and ketamine is a safe and efficient method of limiting anxiety and procedure related pain and can be successfully administered by non-anaesthesiologists. The complication rate is low and can be easily managed.
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Authors | Anupama Borker, Indumati Ambulkar, R Gopal, S H Advani |
Journal | Indian pediatrics
(Indian Pediatr)
Vol. 43
Issue 4
Pg. 309-14
(Apr 2006)
ISSN: 0019-6061 [Print] India |
PMID | 16651669
(Publication Type: Journal Article)
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Chemical References |
- Analgesics
- Hypnotics and Sedatives
- Ketamine
- Midazolam
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Topics |
- Adolescent
- Analgesics
(administration & dosage, adverse effects)
- Child
- Child, Preschool
- Drug Therapy, Combination
- Female
- Follow-Up Studies
- Hematology
(organization & administration)
- Humans
- Hypnotics and Sedatives
(administration & dosage, adverse effects)
- Ketamine
(administration & dosage, adverse effects)
- Male
- Midazolam
(administration & dosage, adverse effects)
- Oncology Service, Hospital
- Pain
(prevention & control)
- Prospective Studies
- Treatment Outcome
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