Premium
Comparison of low‐dose ketamine to midazolam for sedation during pediatric urodynamic study
Author(s) -
Thevaraja Arun K.,
Batra Yatindra Kumar,
Rakesh Sondekoppam V.,
Panda Nidhi B.,
Rao Katragadda L.N.,
Chhabra Monica,
Aggarwal Mayank
Publication year - 2013
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.12046
Subject(s) - medicine , ketamine , midazolam , sedation , anesthesia
Summary Introduction Aim of sedation during pediatric urodynamic studies ( UDS ) is a calm and cooperative child while not affecting measurements. We compared the effectiveness of midazolam to low‐dose ketamine infusion for sedation and their impact on urodynamics. Materials and methods ASA ‐I children undergoing UDS were randomly assigned to group K (ketamine) loading dose (0.25 mg·kg −1 ) followed by infusion of 10–20 μg·kg −1 ·min −1 or group M (midazolam) loading dose of (0.02 mg·kg −1 ) followed by 1–2 μg·kg −1 ·min −1 . The sedation scores and reactivity to catheterization were monitored by C hildren H ospital of W isconsin S edation S cale and F rankl B ehavior R ating S cale, respectively. The UDS included two‐channel filling cystometry in supine position followed by a free uroflowmetry in sitting position. The UDS was performed and interpreted in accordance with good urodynamic practice guidelines of I nternational C ontinence S ociety (2002). Results A total of 34 children were enrolled. G roup K children ( n = 17) attained sedation earlier 6.80 (±3.36) min vs. 9.40 (±2.82) min; ( P = 0.03) than group M ( n = 17) and also recovered earlier 11.60 (±3.13) min vs. 19.67 (±5.49) min ( P = 0.01). Reactivity scores during urinary and rectal catheterization were lower in group K ( P = 0.03 and 0.01), respectively. Historical UDS data of 21 participants were available for comparison with effect of medication. None of the study drugs affected UDS parameters significantly. Conclusions Midazolam or low‐dose ketamine provide satisfactory sedation during pediatric UDS without impacting urodynamic values.