The comparison of different combinations of Ketamine + Midazolam for sedoanalgesia in pediatric patients undergoing cardiac catheterization

Objective: The purpose of this study is to compare the effects of different combinations of ketamine+midazolam on hemodynamics, sedation level, and the recovery period in pediatric kongenital cardiac patients undergoing cardiac catheterization.Material and Method: After the approval of Çukurova University Medicine Faculty Ethics Commitee and parents, 64 patients aged 3 mounth-16 years and undergoing cardiac catheterization were taken in the study. Patients were randomly divided in two groups. Four patients have not been given anesthesia due to enfection. Group K includes 30 patients and Group M includes 34 patients. Ketamine+midazolam group (Group K) has been given 2 mg/kg of ketamine and 0.05 mg/kg midazolam as a bolus for induction. Ketamine+midazolam group (Group M) has been given 2 mg/kg ketamine and 0.1 mg/kg midazolam as a bolus for induction. The infusion of 0.05 mg/kg/h of midazolam for maintenance has been applied on patients. Additional doses of ketamine, 1 mg/kg, were administered when patients wake up, moved, feeling ache or failure sedation in both groups.Hemodynamic data, sedation scores, peripheral saturations of oxygen, ketamine consumption were recorded during the procedure and then moreover, the score of sedation, recovery and eye opening time were recorded after procedure.Results: Demographic properties of two groups were similar (p>0.05). Recovery score at the Group K was higher than Group M after two minutes of the induction, and at the Group M was higher than Group K immediately afterwards procedures, respectivelly(p=0.003) (p=0.021). In this study, we recorded ups and downs that is 20% when compared to baseline and there hasn?t been any statistically different between the goups (p>0.05). However, in Group K there have been ups and downs in more patients. Furthermore although systolic arterial pressure has reached to the level of baseline in Group M, in Group K it couldn?t reach the same point like in Group M. Taken look at the other parameters have been no difference between the groups.Conclusions: In our study, it was concluded that combined use of midazolam and ketamine was resulted in a safe and efficient sedoanalgesia in pediatric patients undergoing cardiac catheterization. Hemodynamic stability was better in the patients received ketamin and midazolam infusion.Key words: Ketamine, midazolam, sedoanalgesia, pediatric cardiac catheterization.