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Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Inhalational Anesthetics: Overview01:20

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Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Sedatives and Hypnotics: Overview01:23

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Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
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Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

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Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
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  11. Ketamine-fentanyl Versus Ketamine-midazolam For Sedation In Children Undergoing Flexible Fiber-optic Bronchoscopy - An Open-label Randomized Controlled Trial.
  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Paediatrics
  9. Infant And Child Health
  11. Ketamine-fentanyl Versus Ketamine-midazolam For Sedation In Children Undergoing Flexible Fiber-optic Bronchoscopy - An Open-label Randomized Controlled Trial.

Related Experiment Video

Guidelines for Elective Pediatric Fiberoptic Intubation
11:19

Guidelines for Elective Pediatric Fiberoptic Intubation

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Ketamine-Fentanyl Versus Ketamine-Midazolam for Sedation in Children Undergoing Flexible Fiber-optic Bronchoscopy - An Open-label Randomized Controlled Trial.

Gopika Ramesh1, Golla Ramakrishna1, Ketan Kumar1

  • 1Department of Pediatrics, AIIMS Bhubaneswar, Odisha, India.

Indian Journal of Pediatrics
|January 6, 2026

View abstract on PubMed

Summary
This summary is machine-generated.
Keywords:
OpioidsPediatric bronchoscopyProcedural sedation

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The ketamine-fentanyl combination did not significantly reduce severe cough episodes during pediatric flexible fiberoptic bronchoscopy (FOB) compared to ketamine-midazolam. Post-hoc analysis suggested a potential benefit, with no increased adverse events observed.

Area of Science:

  • Pediatric Anesthesiology
  • Respiratory Medicine
  • Procedural Sedation

Background:

  • Flexible fiberoptic bronchoscopy (FOB) is a common pediatric procedure.
  • Coughing during FOB can complicate the procedure and patient recovery.
  • Optimizing sedation regimens is crucial for pediatric procedural success.

Purpose of the Study:

  • To compare the efficacy of ketamine-fentanyl (KF) versus ketamine-midazolam (KM) in reducing severe cough episodes during pediatric FOB.
  • To evaluate the safety profile of KF compared to KM in this patient population.

Main Methods:

  • A randomized controlled trial enrolled 75 children aged 6 months to 15 years undergoing FOB.
  • Participants received either intravenous ketamine and fentanyl (KF group) or ketamine and midazolam (KM group).
  • Video recordings were reviewed by a blinded observer to quantify severe cough episodes.

    • Main Results:

    • The ketamine-fentanyl group showed a trend towards fewer severe cough episodes (median 1 vs. 3), but this was not statistically significant (P=0.054).
    • Post-hoc analysis revealed a significantly lower frequency of severe cough episodes per minute in the KF group (P=0.008).
    • No significant differences were observed in sedation depth, procedure scores, need for additional sedation, or adverse events, including bradycardia, hypotension, or apnea.

    Conclusions:

    • The ketamine-fentanyl combination did not achieve statistical significance in reducing severe cough episodes during pediatric FOB compared to ketamine-midazolam.
    • Post-hoc findings suggest a potential benefit of ketamine-fentanyl for cough suppression.
    • The KF combination was found to be safe, with no increase in adverse events.