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Ketamine AND midazolam AND child AND oncology

Kathryn Michalczyk, Janice E Sullivan, John W Berkenbosch
OBJECTIVE: Ketamine has a long history of use during pediatric procedural sedation. Concerns about raising intracranial pressure may limit use in certain situations. Whereas some data suggest that benzodiazepine coadministration may blunt this response, pediatric data during procedural sedation do not exist. We evaluated the effects of midazolam pretreatment on intracranial pressure during ketamine sedation in children. DESIGN: Prospective, randomized clinical study...
March 2013: Pediatric Critical Care Medicine
Sushma Bhatnagar, Seema Mishra, Meenu Gupta, Madhurima Srikanti, Anindya Mondol, Alok Diwedi
AIM: To evaluate the efficacy and safety of a mixture of ketamine, midazolam and atropine given orally by comparing the same mixture given through the intramuscular route in children with malignancy undergoing minor invasive procedures. METHODS: Sixty children, aged between 1 and 10 years, scheduled to undergo minor procedures were randomised into two groups to receive a mixture of ketamine (6 mg/kg), midazolam (0.05 mg/kg) and atropine (0.02 mg/kg) intramuscularly (Group 1) or ketamine (10 mg/kg), midazolam (0...
April 2008: Journal of Paediatrics and Child Health
Anupama Borker, Indumati Ambulkar, R Gopal, S H Advani
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...
April 2006: Indian Pediatrics
Sven Gottschling, Sascha Meyer, Thomas Krenn, Harald Reinhard, Daniela Lothschuetz, Holger Nunold, Norbert Graf
Different pharmacologic agents have been used for sedation in children undergoing invasive procedures. The authors prospectively compared the efficacy, the occurrence of adverse effects, cardiovascular parameters, oxygen saturation and induction, and recovery time in propofol with or without morphine versus midazolam/ketamine sedation for procedural sedation in children with malignancies and hematologic disorders. Fifty children received either propofol with or without morphine or ketamine/midazolam sedation for invasive procedures...
September 2005: Journal of Pediatric Hematology/oncology
D K L Cheuk, W H S Wong, E Ma, T L Lee, S Y Ha, Y L Lau, G C F Chan
OBJECTIVES: 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...
December 2005: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Sascha Meyer, Schahin Aliani, Norbert Graf, Harald Reinhard, Sven Gottschling
Different pharmacological agents have been used for sedation in children undergoing invasive procedures. The authors prospectively evaluated the efficacy, the occurrence of adverse side effects, and cardiovascular parameters in midazolam and ketamine sedation for invasive procedures in children with malignancies and hematological disorders. A total of 183 invasive procedures were performed on 63 children (mean age 9.2 +/- 5.2 years). Intravenous sedation consisted of 0.1 mg midazolam/kg and 1.0 mg ketamine/kg...
June 2003: Pediatric Hematology and Oncology
P Klepstad, P Borchgrevink, B Hval, S Flaat, S Kaasa
A 12-year-old girl presented with head and neck pain, myoclonic movements, and decreased strength in all extremities caused by a cervical spinal tumor (glioblastoma multiforme). A partial resection of the tumor was performed. Three weeks later, she had superficial pain distributed in all dermatomes below her cervical medullary lesion. Touch (e.g., gentle hugs from relatives) and movements elicited paroxysm of intense pain. The pain was not relieved by increased doses of morphine. A test dose of ketamine (7...
December 2001: Journal of Pediatric Hematology/oncology
I Pellier, J P Monrigal, P Le Moine, B Rod, X Rialland, J C Granry
We evaluated the safety and efficacy of midazolam-ketamine association to control pain induced by diagnostic procedures in paediatric oncology patients. 226 procedures were carried out in 92 patients aged three days to 18 years. Drugs were given i.v. by an anaesthesiologist. Midazolam dose was 25 and ketamine 0. 5 to 2, depending on number and invasiveness of procedures. The mean dose of ketamine was 1 Mean duration of sedation was ten min. No complication was observed and analgesia was considered satisfactory in 89 out of 92 patients...
1999: Paediatric Anaesthesia
C M Marx, J Stein, M K Tyler, M L Nieder, S B Shurin, J L Blumer
PURPOSE: To compare the efficacy, characteristics of onset/recovery, and safety of ketamine/atropine/midazolam with meperidine/midazolam used as premedication for painful procedures in children with cancer. METHODS: A randomized, double-blind crossover trial for two successive painful procedures (bone marrow aspiration or biopsy, lumbar puncture, or combined procedures) was performed at a referral-based pediatric hematology-oncology clinic and associated inpatient service of a university teaching hospital...
January 1997: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
A M Broennle, D E Cohen
Advances in pediatric anesthesia can contribute to improved care of children in other environments. As an example, drugs and dosages established in preoperative sedation of children provide a base for their application in sedation and pain relief of children undergoing painful procedures in the emergency unit, oncology treatment area, and radiology suite. Midazolam, ketamine, fentanyl, propofol, chloral hydrate, and pentobarbital are reviewed from the past year's pediatric literature. Adverse sequelae of sedation including hypoxemia and hypoventilation or apnea confirm the need for an individual whose responsibility is observation and support of the sedated child rather than performing the procedure, a principle that is the cornerstone of revised guidelines for the use of sedation in children...
June 1993: Current Opinion in Pediatrics
J D Tobias, S Phipps, B Smith, R K Mulhern
This study prospectively evaluated the efficacy of oral ketamine in alleviating procedure-related distress in pediatric oncology patients. Ketamine (10 mg/kg) was administered orally to 35 children and adolescents, ranging in age from 14 months to 17 years (mean = 6.5 years). Procedure-related distress was evaluated by using parent/clinician ratings and the Observational Scale of Behavioral Distress (OSBD-R). Eighty-seven percent of children were sedated within 45 minutes. Clinician and parent ratings were similar, with 77% rating procedural distress as low (0 to 3)...
October 1992: Pediatrics
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