Abstract
Background:Different drug regimens can be used for management of anxiety before endoscopy. This study aimed to compare the sedation effects of propofol+ketamine (PK) and sodium thiopental+fentanyl (TF) in children during upper gastrointestinal (UGI) endoscopy.Methods:A triple-blind clinical trial was conducted on 88 children aged 2-12 years who were candidate for UGI endoscopy at Children’s Medical Centre, Tehran, Iran, during 2012-2013. It was administered propofol (2.1 mg/kg) + ketamine (1 mg/kg) and 100% oxygen in PK group, and thiopental (5 mg/kg) + fentanyl (1 mg/kg) in TF group. The haemodynamic status and degree of sedation by Ramsay’s criteria were measured.Results:The mean age in PK and TF groups was 92.2±38.2 and 98.6±49.5 months, respectively. The systolic blood pressure and heart rate significantly increased and decreased in PK and TF groups during the procedure, respectively. The frequency of Ramsay's Sedation Scales of 5 and 6 were respectively 72.7% and 27.3% for PF, and 54.5% and 45.5% for TF group (p=0.076).Conclusion:Although both groups were similar in the degree of sedation, PK can be a more appropriate choice for sedation in children with special diseases undergoing endoscopy due to small changes in haemodynamic parameters and, consequently, their higher stability.
Highlights
Preparation for the endoscopy procedure in children requires full knowledge of physiology and suitable mental state of both the child and the person performing the procedure [1]
44 children were induced with propofol+ketamine, and 44 children were induced with thiopental
In terms of haemodynamic parameters, the mean baseline systolic blood pressure in the group induced with propofol+ketamine was 92.21±10.17 mm Hg, which increased to 94.85±18.58 mm Hg during the procedure
Summary
Preparation for the endoscopy procedure in children requires full knowledge of physiology and suitable mental state of both the child and the person performing the procedure [1]. Tongue fills a higher portion of the air duct compared to adults This happens mainly in children younger than 3-5 months. Episodes of hypoxemia occur more often in these children due to their higher oxygen consumption In this respect, routine administration of oxygen during the endoscopic procedures is an inexpensive way to improve breathing condition and the sedation required for endoscopy in children [12,13,14]. Methods: A triple-blind clinical trial was conducted on 88 children aged 2-12 years who were candidate for UGI endoscopy at Children’s Medical Centre, Tehran, Iran, during 2012-2013 It was administered propofol (2.1 mg/kg) + ketamine (1 mg/kg) and 100% oxygen in PK group, and thiopental (5 mg/kg) + fentanyl (1 mg/kg) in TF group. Conclusion: both groups were similar in the degree of sedation, PK can be a more appropriate choice for sedation in children with special diseases undergoing endoscopy due to small changes in haemodynamic parameters and, their higher stability
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