Comparative study between inj. Ketamine hcl-Midazolam hcl & inj. Fentanyl citrate- Midazolam hcl in Paediatric Patient for Procedural Sedation (RT/CT/MRI).

ABSTRACT

Introduction: Interaction with medical providers is stressful experience for children. Because of this stress and the anxiety, minor procedures often require mild to moderate sedation. Sedation of the paediatric patient is a process carefully planned by the anaesthesia provider while maintaining the heart rate, respiration & oxygen saturation levels at the patient's baseline values. Methodology: We studied 80 patients of either sex aged 2-10 years of ASA grade-1 and 2, undergoing Radiation therapy, CT Scan and MRI. They were randomly allocated in two groups 40 each to compare the efficacy, safety, and tolerability of inj. Ketamine - Midazolam combination to inj. Fentanyl - Midazolam combination for sedation of children during Radiation Therapy (RT)/Computerised Tomography Scan (CT Scan)/Magnetic Resonance Imagine(MRI). Both the groups were given IV inj. Midazolam 0.05 mg/kg before giving IV inj. Ketamine 1 mg/kg in group 1 while IV inj. Fentanyl 2 pg/kg in group 2. Result: In both groups after giving sedation, there were no significant changes in heart rate. Degree of sedation was better in group I than in group II. Recovery from sedation was more prolonged in group 1 than in group 2. Conclusion: It was found that inj. Ketamine-Midazolam combination offers good sedation without compromising respiration but more prolonged recovery and higher incidence of post procedural vomiting, while inj. Fentanyl-Midazolam combination has lower sedation score and higher incidence of respiratory depression.