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A Comparative Study of the Effect of Midazolam-Ketamine and Midazolam-Propofol in Children 1 to 10 years old

Anahid Maleki, Ebrahim Spahbodi, Ali Reza Ebrahim Soltani, Abbas Ostad Alipour, Mehrdad Goudarzi, Alireza Takazare

Abstract


Objective: The aim of this study was to evaluate the effect of midazolam-ketamine and midazolam-propofol in children aged 1 to 10 years under endoscopy.

Materials and Methods: This cross-sectional study was performed on 60 children aged 1 to 10 years old who were non-emergency candidates for upper gastrointestinal tracheal endoscopy who referred to the pediatric medical center hospital. The samples were randomly divided in quadruple blocks into two groups of midazolam-ketamine and midazolam-propofol. Both groups were injected 0.05 mg / kg of midazolam and group one received 2 mg / kg of ketamine and the second group received 2mg / kg of propofol and oxygen was administered to the patient. Age, sex, weight of referral time, duration of patient's stay in recovery, mean endoscopic time, respiratory state based on saturation, gagging condition and presence of nausea and vomiting, recovery time after endoscopy, until complete waking, apnea, laryngospasm and insufficiency level of anesthesia was recorded by a third person on the checklist. Data were analyzed using SPSS version 20 and Chi-square and independent t-test.

Results: The mean age, mean endoscopy duration in minutes, mean of weight, frequency of sex, gag reflux rate, and incidence of insufficiency anaesthesia in two groups were not significantly different. But the average recovery time in minutes was significantly different in the two groups. The incidence of nausea and vomiting in the midazolam-ketamine group (33.3%) was more than midazolam-propofol (10%) (P = 0.05). The incidence of apnea in the midazolam-ketamine (0%) group was less than midazolam-propofol (23.3%) (P = 0.005). The incidence of laryngospasm was negative in all patients. The incidence of o2Sat less than 90 in the midazolam-ketamine (3.3%) group was less than midazolam-propofol group (23.3%) (P = 0.02).

Conclusion: Pain and restlessness during children's endoscopy necessitate the use of medication for sedation during endoscopy.


Keywords


children, children one to ten, endoscopy, propofol, ketamine, midazolam

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References


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