Analgesic efficacy of intramuscular ketamine/ketorolac versus fentanyl/ketorolac for children undergoing bone marrow biopsy and aspiration

Abstract

Background Bone marrow aspiration and/or biopsy (BMAB) in children with hematological disorders is a painful procedure, is required to be repeated at regular intervals, and is under researched. Objective To compare intramuscular administration of fentanyl/ketorolac (F) versus ketamine/ketorolac (K) as an analgesic regimen in pediatric population undergoing BMAB under general anesthesia. A total of 80 children underwent BMAB under general anesthesia, who were randomized into two equal groups: group K received ketamine 0.5 mg/kg/ketorolac 1 mg/kg and group F received fentanyl 1.5 μg/kg/ketorolac 1 mg/kg. The study drugs are injected intramuscularly after induction of general anesthesia. Result No statistically significant difference was found between groups regarding patient characteristics, duration of procedure or duration of anesthesia, pain score, time to first analgesic request, emergence-agitation score, or incidence of vomiting. There was a significant decrease in heart rate, systolic blood pressure, and respiratory rate in both groups at 15 and 20 min compared with basal values. Conclusion Ketamine 0.5 mg/kg+ketorolac 1 mg/kg and fentanyl 1.5 μg/kg+ketorolac 1 mg/kg administered intramuscular are similarly effective analgesic regimens in pediatric population undergoing BMAB under general anesthesia without adverse effects.