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2015 ; 3
(2
): 64-9
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Oral Midazolam-Ketamine versus Midazolam alone for Procedural Sedation of
Children Undergoing Computed Tomography; a Randomized Clinical Trial
#MMPMID26495384
Majidinejad S
; Taherian K
; Esmailian M
; Khazaei M
; Samaie V
Emerg (Tehran)
2015[Spr]; 3
(2
): 64-9
PMID26495384
show ga
INTRODUCTION: Motion artifacts are a common problem in pediatric radiographic
studies and are a common indication for pediatric procedural sedation. This study
aimed to compare the combination of oral midazolam and ketamine (OMK) with oral
midazolam alone (OM) as procedural sedatives among children undergoing computed
tomography (CT) imaging. METHODS: The study population was comprised of six-month
to six-year old patients with medium-risk minor head trauma, who were scheduled
to undergo brain CT imaging. Patients were randomly allocated to two groups: one
group received 0.5 mg/kg midazolam (OM group; n = 33) orally and the other one
received 0.2 mg/kg midazolam and 5 mg/kg ketamine orally (OMK group; n=33). The
vital signs were monitored and recorded at regular intervals. The primary outcome
measure was the success rate of each drug in achieving adequate sedation.
Secondary outcome measures were the time to achieve adequate sedation, time to
discharge from radiology department, and the incidence of adverse events.
RESULTS: Adequate sedation was achieved in five patients (15.2%) in OM group and
15 patients (45.5%) in OMK group, which showed a statistically significant
difference between the groups (p = 0.015). No significant difference was noted
between OM and OMK groups with respect to the time of achieving adequate sedation
(33.80 ± 7.56 and 32.87 ± 10.18 minutes, respectively; p = 0.854) and the time of
discharging from radiology department (89.60 ± 30.22 and 105.27 ± 21.98 minutes,
respectively; p=0.223). The complications were minor and similar among patients
of both groups. CONCLUSION: This study demonstrated that in comparison with OM,
OMK was more effective in producing a satisfactory level of sedation in children
undergoing CT examinations without additional complications; however, none of
these two regimens fulfilled clinical needs for procedural sedation.