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Paper Information

Journal:   TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)   SEPTEMBER 2007 , Volume 65 , Number 6; Page(s) 17 To 22.
 
Paper: 

PROPOFOL-ALFENTANYL VERSUS MIDAZOLAM-KETAMINE FOR SEDATION AND ANALGESIA DURING BONE MARROW ASPIRATION IN CHILDREN

 
 
Author(s):  DARABI M.E., MIRESKANDARI S.M., SADEGHI. M.*
 
* DEPT. OF ESTHESIA, SHARIATI HOSPITAL, TEHRAN, IRAN
 
Abstract: 

Background: Invasive procedures such as bone marrow aspiration in children with oncologic malignancies are painful and may produce anxiety for both patients and their parents. Various pharrnacologic treatments have been used to sedate children undergoing bone marrow aspiration. This prospective randomized study was designed to compare the effectiveness of these combinations, as well as their associated hemodynamic and respiratory side-effects and recovery in pediatric patients undergoing bone marrow aspiration.
Methods: Fifty children with oncologic malignancies whose ages ranged between 2- 12 years were emolled in this study. Patients were randomly assigned either to the Propofol- Alfentanyl group or the Midazolam- Ketamine group for analgesia and sedation during bone marrow aspiration in the operating room. Time to induce sedation, sedation score and recovery time were recorded.
Results: There were no statistical differences between groups in weight, age, sex and duration of procedures. Procedures were completed with satisfactory sedation levels in all patients in the study groups according to the modified Ramsay score. Induction and recovery times in the Propofol- Alfentanyl group were significantly shorter than in the Midazolam- Ketamine group (p<0.001).fter Midazolam- Ketamine sedation, a statistically significant increase in systolic blood pressure and heart rate were seen, however the opposite was observed after Propofol- Alfentanyl sedation. Other side effects, such as nausea and vomiting, agitation myoclonus and aspiration, were not seen in our patients.
Conclusion: Both Propofol- Alfentanyl and Midazalam-Ketamine combinations can be used safely and effectively for sedation and analgesia during bone marrow aspiration in the pediatric patient group.

 
Keyword(s): MIDAZOLAM, KETAMINE, ALFENTANYL, PROPOFOL, CHILDREN, BONE MARROW ASPIRATION, SEDATION
 
References: 
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