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Article: Use of midazolam and ketamine as sedation for children undergoing minor operative procedures

TitleUse of midazolam and ketamine as sedation for children undergoing minor operative procedures
Authors
KeywordsChildren
Ketamine
Midazolam
Oncology
Sedation
Issue Date2005
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00520/index.htm
Citation
Supportive Care In Cancer, 2005, v. 13 n. 12, p. 1001-1009 How to Cite?
AbstractObjectives: We used intravenous midazolam and ketamine for children undergoing minor operative procedures with satisfactory results. We aimed to further evaluate its efficacy and adverse effects in pediatric ward setting. Methods: This was a prospective study of all children undergoing minor operations with sedation in our pediatric general and oncology wards from July 1998 to June 1999. The procedures included lumber puncture±intrathecal chemotherapy, bone marrow aspiration±trephine biopsy, central venous catheter removal, skin biopsy, or their combination. All sedation procedures were started with midazolam 0.1 mg/kg and ketamine 1 mg/kg; they were increased gradually to 0.4 and 4 mg/kg, respectively, if necessary. Heart rate and SaO2 were continuously monitored. Results: Altogether, 369 minor operations were performed in 112 patients (male:female=2:1, median age 6 years, range 5 months-17 years). All achieved adequate sedation, with 96% within 30 s and 75% required just the starting dose. Younger children required a higher dosage (p=0.003 for midazolam, p<0.001 for ketamine). The median recovery time was 87 min, with no association with age, sex, or dosage of sedation, but was longer in patients having hallucination (p=0.001). Adverse effects included tachycardia (27.9%), increased secretion (17.6%), agitation (13.6%), nausea and vomiting (9.2%), hallucination (8.7%), desaturation (8.4%), and cataleptic reaction (0.8%). All desaturation episodes were transient and responded to oxygen supplement alone. None developed bronchospasm or convulsion. Some adverse effects were dose-related. Half of the children who received 0.3 mg/kg midazolam developed desaturation. Conclusions: Intravenous midazolam-ketamine can provide rapid, effective, and safe sedation for children undergoing minor operations in ward setting. Adverse effects are mild. Midazolam above 0.3 mg/kg should be used with caution. © Springer-Verlag 2005.
Persistent Identifierhttp://hdl.handle.net/10722/79912
ISSN
2015 Impact Factor: 2.535
2015 SCImago Journal Rankings: 1.267
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheuk, DKLen_HK
dc.contributor.authorWong, WHSen_HK
dc.contributor.authorMa, Een_HK
dc.contributor.authorLee, TLen_HK
dc.contributor.authorHa, SYen_HK
dc.contributor.authorLau, YLen_HK
dc.contributor.authorChan, GCFen_HK
dc.date.accessioned2010-09-06T08:00:12Z-
dc.date.available2010-09-06T08:00:12Z-
dc.date.issued2005en_HK
dc.identifier.citationSupportive Care In Cancer, 2005, v. 13 n. 12, p. 1001-1009en_HK
dc.identifier.issn0941-4355en_HK
dc.identifier.urihttp://hdl.handle.net/10722/79912-
dc.description.abstractObjectives: We used intravenous midazolam and ketamine for children undergoing minor operative procedures with satisfactory results. We aimed to further evaluate its efficacy and adverse effects in pediatric ward setting. Methods: This was a prospective study of all children undergoing minor operations with sedation in our pediatric general and oncology wards from July 1998 to June 1999. The procedures included lumber puncture±intrathecal chemotherapy, bone marrow aspiration±trephine biopsy, central venous catheter removal, skin biopsy, or their combination. All sedation procedures were started with midazolam 0.1 mg/kg and ketamine 1 mg/kg; they were increased gradually to 0.4 and 4 mg/kg, respectively, if necessary. Heart rate and SaO2 were continuously monitored. Results: Altogether, 369 minor operations were performed in 112 patients (male:female=2:1, median age 6 years, range 5 months-17 years). All achieved adequate sedation, with 96% within 30 s and 75% required just the starting dose. Younger children required a higher dosage (p=0.003 for midazolam, p<0.001 for ketamine). The median recovery time was 87 min, with no association with age, sex, or dosage of sedation, but was longer in patients having hallucination (p=0.001). Adverse effects included tachycardia (27.9%), increased secretion (17.6%), agitation (13.6%), nausea and vomiting (9.2%), hallucination (8.7%), desaturation (8.4%), and cataleptic reaction (0.8%). All desaturation episodes were transient and responded to oxygen supplement alone. None developed bronchospasm or convulsion. Some adverse effects were dose-related. Half of the children who received 0.3 mg/kg midazolam developed desaturation. Conclusions: Intravenous midazolam-ketamine can provide rapid, effective, and safe sedation for children undergoing minor operations in ward setting. Adverse effects are mild. Midazolam above 0.3 mg/kg should be used with caution. © Springer-Verlag 2005.en_HK
dc.languageengen_HK
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00520/index.htmen_HK
dc.relation.ispartofSupportive Care in Canceren_HK
dc.subjectChildrenen_HK
dc.subjectKetamineen_HK
dc.subjectMidazolamen_HK
dc.subjectOncologyen_HK
dc.subjectSedationen_HK
dc.titleUse of midazolam and ketamine as sedation for children undergoing minor operative proceduresen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0941-4355&volume=13&spage=1001&epage=1009&date=2005&atitle=Use+of+midazolam+and+ketamine+as+sedation+for+children+undergoing+minor+operative+procedures.en_HK
dc.identifier.emailLau, YL:lauylung@hkucc.hku.hken_HK
dc.identifier.emailChan, GCF:gcfchan@hkucc.hku.hken_HK
dc.identifier.authorityLau, YL=rp00361en_HK
dc.identifier.authorityChan, GCF=rp00431en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00520-005-0821-8en_HK
dc.identifier.pmid15846522-
dc.identifier.scopuseid_2-s2.0-27744496500en_HK
dc.identifier.hkuros111082en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-27744496500&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume13en_HK
dc.identifier.issue12en_HK
dc.identifier.spage1001en_HK
dc.identifier.epage1009en_HK
dc.identifier.isiWOS:000233349300007-
dc.publisher.placeGermanyen_HK
dc.identifier.scopusauthoridCheuk, DKL=8705936100en_HK
dc.identifier.scopusauthoridWong, WHS=13310222200en_HK
dc.identifier.scopusauthoridMa, E=7202039934en_HK
dc.identifier.scopusauthoridLee, TL=8508917400en_HK
dc.identifier.scopusauthoridHa, SY=7202501115en_HK
dc.identifier.scopusauthoridLau, YL=7201403380en_HK
dc.identifier.scopusauthoridChan, GCF=16160154400en_HK

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