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J Korean Soc Emerg Med > Volume 29(1); 2018 > Article
Journal of The Korean Society of Emergency Medicine 2018;29(1): 30-36.
소아 환자에서 요추천자를 시행하기 위한 진정제의 선택: 케타민-미다졸람과 케타민-프로포폴의 진정 효과 비교
고유라1, 전우찬2, 곽재령1, 이지숙1*
1아주대학교 의과대학 응급의학교실
2인제대학교 일산백병원 응급의학과
A Comparison of Sedation with Ketamine-Midazolam versus Ketamine-Propofol for the Lumbar Puncture in Children
Yu Ra Ko1, Woochan Jeon2, Jae Ryoung Kwak1, Ji Sook Lee1*
1Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
2Department of Emergency Medicine, Ilsan Paik Hospital, Inje University, Goyang, Korea
Correspondence  Ji Sook Lee ,Tel: 031-219-7756, Fax: 031-219-7760, Email: eesysook@naver.com,
Received: September 22, 2017; Revised: September 25, 2017   Accepted: October 22, 2017.  Published online: February 28, 2018.
ABSTRACT
Purpose:
This study was conducted to compare the safety and effectiveness of intravenous ketamine-midazolam (KM) and ketamine-propofol (KP) combination for the lumbar puncture (LP) procedure in children.
Method:
This was a retrospective analysis of patients aged ≤18 years old who received intravenous injection of KM or KP for undergoing LP in the pediatric emergency department. To investigate the effectiveness of KM and KP, we compared the sedation success rate, induction time, procedure time and total sedation time. In addition, adverse events and complications were recorded to assess the safety of the agents.
Results
A total 61 patients were enrolled in study. Twenty-eight patients were given KM and 33 patients received KP. All sedations were successful in both groups. While the mean induction time in KM was shorter than in the KP group (3±4 vs. 6±5 minutes, p=0.02), the total sedation time in the KP group was significantly shorter than that in the KM group (33±26 vs. 61±43 minutes, p<0.01). There were no adverse effects such as hypotension, bradycardia or hypoxic event.
Conclusion:
This study showed that intravenous KM and KP are hemodynamically stable and have few side effects when applied for pediatric sedation during lumbar puncture. Although KM has a shorter induction time than KP, KP has a shorter duration of sedation. Both of these materials can be considered useful agents for sedation when conducting painful procedures in children.
Key words: Ketamine, Midazolam, Propofol, Conscious sedation, Children
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