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Background . Ketamine sedation has been found superior by physician report to traditional sedation regimens for pediatric endoscopy.  Goal . To objectively compare sedation with ketamine versus midazolam/fentanyl for children undergoing gastrointestinal endoscopy.  Study . Patients received one of two regimens and were independently monitored using a standardized rating scale.  Results . There were 2 episodes of laryngospasm during ketamine sedation. Univariate analyses showed patients sedated with ketamine ( n  = 17) moved more (median 25% of procedure time versus 8%,  P  = .03) and required similar low levels of restraint (0.83% versus 0.25%,  P  = .4) as patients sedated with midazolam/fentanyl ( n  = 20). Age-adjusted analyses suggested that patients sedated with ketamine were comparably more quiet ( P  = .002).  Conclusions . A pilot trial of ketamine at our institution was associated with episodes of laryngospasm. In addition, children sedated with ketamine moved and required restraint similarly to patients sedated with midazolam/fentanyl. Physician perceptions may be affected by the fact that children who received ketamine were less likely to vocalize distress.

A Pilot Study of Ketamine versus Midazolam/Fentanyl Sedation in Children Undergoing GI Endoscopy