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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
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Published on: December 6, 2016

Midazolam-ketamine combination for moderate sedation in upper GI endoscopy

Farzaneh Motamed1, Yasaman Aminpour, Hesam Hashemian

  • 1Department of Gastroenterology, Tehran University of Medical Sciences, Tehran, Iran.

Journal of Pediatric Gastroenterology and Nutrition
|August 23, 2011
PubMed

Insights

Oral ketamine with IV midazolam provided safe and effective sedation for pediatric upper gastrointestinal endoscopy (UGIE). This combination led to better patient comfort and faster recovery compared to other regimens.

Area of Science:

  • Pediatric Gastroenterology
  • Anesthesiology
  • Sedation Pharmacology

Background:

  • Effective sedation is crucial for pediatric upper gastrointestinal endoscopy (UGIE) to ensure patient comfort and procedural success.
  • Optimizing sedation regimens in children requires balancing efficacy, safety, and patient experience.

Purpose of the Study:

  • To compare the quality of sedation using three distinct regimens in pediatric patients undergoing UGIE.
  • To evaluate the efficacy and safety of oral ketamine and intravenous midazolam compared to placebo and oral fentanyl.

Main Methods:

  • A randomized study involving 150 pediatric patients undergoing UGIE.
  • Three groups received different sedation: Group A (placebo + IV midazolam), Group B (oral ketamine + IV midazolam), and Group C (oral fentanyl + IV midazolam).
  • Sedation depth and patient comfort were primary endpoints, with safety and recovery time also assessed.

Main Results:

  • Group B (oral ketamine + IV midazolam) demonstrated significantly lower midazolam requirements.
  • Patients in Group B experienced less distress during IV placement and parental separation, higher comfort, and greater endoscopist satisfaction.
  • Group B showed a shorter recovery time, with all regimens proving safe and complications managed successfully.

Conclusions:

  • Synergistic sedation with oral ketamine and IV midazolam is a safe and suitable option for pediatric UGIE.
  • The oral route of ketamine administration may contribute to a higher incidence of vomiting compared to previous studies.
  • This regimen offers advantages in terms of patient comfort, procedural ease, and recovery efficiency.
Abstract

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