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Comparison of propofol versus propofol–ketamine combination in pediatric oncologic procedures performed by non‐anesthesiologists
Author(s) -
Chiaretti Antonio,
Ruggiero Antonio,
Barbi Egidio,
Pierri Filomena,
Maurizi Palma,
Fantacci Claudia,
Bersani Giulia,
Riccardi Riccardo
Publication year - 2011
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.23170
Subject(s) - propofol , medicine , ketamine , sedation , anesthesia , incidence (geometry) , american society of anesthesiologists , adverse effect , physics , optics
Background Limited data are available on the best option (short acting sedatives, opioids, or ketamine) in oncologic procedural sedation performed by non‐anesthesiologists. The aim of the present prospective study is to compare the safety and efficacy of propofol–ketamine versus propofol alone, managed by trained pediatricians, in children with cancer undergoing painful procedures. Procedures Data on 121 children with acute lymphatic leukemia (ALL) undergoing procedural sedations (lumbar punctures and bone marrow aspirations) were prospectively collected and included drug doses, side effects, pain assessment, and sedation degree. Children were randomly assigned to one of the two groups: P (n = 62) receiving propofol alone and K (n = 59) in whom a ketamine–propofol combination was used. Results In group K, the total dose of propofol required was significantly lower than in group P (3.9 ± 3.6 mg/kg vs. 5.1 ± 3.6 mg/kg; P < 0.001). The incidence of hypotension was also significantly lower (11% vs. 39%; P < 0.001). Major O 2 desaturations (defined as SatO 2 < 88%) occurred principally in group P (7 vs. 1; P = 0.05). Both best analgesia and shorter recovery time were obtained with the propofol–ketamine association. No differences were observed in the degree of sedation and in the awakening quality score between the two groups. Conclusions The combination of propofol and ketamine produced statistically significant clinical advantages combined with a higher profile of safety in children with cancer undergoing painful procedures. Pediatr Blood Cancer 2011; 57: 1163–1167. © 2011 Wiley Periodicals, Inc.