TY - JOUR T1 - Comparison of propofol versus propofol-ketamine combination in pediatric oncologic procedures performed by non-anesthesiologists. JF - Pediatr Blood Cancer Y1 - 2011 A1 - Chiaretti, Antonio A1 - Ruggiero, Antonio A1 - Barbi, Egidio A1 - Pierri, Filomena A1 - Maurizi, Palma A1 - Fantacci, Claudia A1 - Bersani, Giulia A1 - Riccardi, Riccardo KW - Biopsy, Needle KW - Bone Marrow Examination KW - Child KW - Conscious Sedation KW - Female KW - Humans KW - Hypnotics and Sedatives KW - Ketamine KW - Male KW - Neoplasms KW - Pediatrics KW - Physicians KW - Propofol KW - Spinal Puncture AB -

BACKGROUND: Limited data are available on the best option (short acting sedatives, opioids, or ketamine) in oncologic procedural sedation performed by non-anesthesiologists. The aim of the present prospective study is to compare the safety and efficacy of propofol-ketamine versus propofol alone, managed by trained pediatricians, in children with cancer undergoing painful procedures.

PROCEDURES: Data on 121 children with acute lymphatic leukemia (ALL) undergoing procedural sedations (lumbar punctures and bone marrow aspirations) were prospectively collected and included drug doses, side effects, pain assessment, and sedation degree. Children were randomly assigned to one of the two groups: P (n = 62) receiving propofol alone and K (n = 59) in whom a ketamine-propofol combination was used.

RESULTS: In group K, the total dose of propofol required was significantly lower than in group P (3.9 ± 3.6 mg/kg vs. 5.1 ± 3.6 mg/kg; P < 0.001). The incidence of hypotension was also significantly lower (11% vs. 39%; P < 0.001). Major O(2) desaturations (defined as SatO(2) < 88%) occurred principally in group P (7 vs. 1; P = 0.05). Both best analgesia and shorter recovery time were obtained with the propofol-ketamine association. No differences were observed in the degree of sedation and in the awakening quality score between the two groups.

CONCLUSIONS: The combination of propofol and ketamine produced statistically significant clinical advantages combined with a higher profile of safety in children with cancer undergoing painful procedures.

VL - 57 IS - 7 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21584935?dopt=Abstract ER -