J Korean Soc Emerg Med.  2018 Feb;29(1):30-36. 10.0000/jksem.2018.29.1.30.

A Comparison of Sedation with Ketamine-Midazolam versus Ketamine-Propofol for the Lumbar Puncture in Children

• Ko YR
• Jeon W
• Kwak JR
• Lee JS

• KMID: 2435564
• DOI: http://doi.org/10.0000/jksem.2018.29.1.30

Abstract

PURPOSE
This study was conducted to compare the safety and effectiveness of intravenous ketamine-midazolam (KM) and ketamine-propofol (KP) combination for the lumbar puncture (LP) procedure in children.
METHODS
This was a retrospective analysis of patients aged ≤18 years old who received intravenous injection of KM or KP for undergoing LP in the pediatric emergency department. To investigate the effectiveness of KM and KP, we compared the sedation success rate, induction time, procedure time and total sedation time. In addition, adverse events and complications were recorded to assess the safety of the agents.
RESULTS
A total 61 patients were enrolled in study. Twenty-eight patients were given KM and 33 patients received KP. All sedations were successful in both groups. While the mean induction time in KM was shorter than in the KP group (3±4 vs. 6±5 minutes, p=0.02), the total sedation time in the KP group was significantly shorter than that in the KM group (33±26 vs. 61±43 minutes, p < 0.01). There were no adverse effects such as hypotension, bradycardia or hypoxic event.
CONCLUSION
This study showed that intravenous KM and KP are hemodynamically stable and have few side effects when applied for pediatric sedation during lumbar puncture. Although KM has a shorter induction time than KP, KP has a shorter duration of sedation. Both of these materials can be considered useful agents for sedation when conducting painful procedures in children.

Keyword

Ketamine; Midazolam; Propofol; Conscious sedation; Children

MeSH Terms

Bradycardia
Child*
Conscious Sedation
Emergency Service, Hospital
Humans
Hypotension
Injections, Intravenous
Ketamine
Midazolam
Propofol
Retrospective Studies
Spinal Puncture*
Ketamine
Midazolam
Propofol