The factors of ketamine that affect sedation in children with oncology procedures parent satisfaction perspective.
The pain and its complication during sedation with ketamine remain a significant problem for children with hematologic malignancy. The purpose of the present study was to evaluate further the parental satisfaction for procedural sedation and analgesia during pediatric hematologyoncology procedures perfonned by pediatrician in the Department of Pediatrics, Phramongkutklao Hospital. The authors prospectively evaluated our experience using intravenous ketamine 1 mgkg for oncology patients undergoing procedures at Department ofPediatrics, Phramongkutklao Hospital. The procedure was assessed by way ofaphysician-completed form and by evaluation of questionnaires given to parents to estimate levels of pain by using a 0 to 10 mm visual analog scale (VAS) at 2 hours after procedures and results in any adverse events with respect to age, gende, procedures performed, ketamine dosage and recovery time. Total of46 children aged 6 months to 15 years with 46procedures were observed at pediatric unit post-procedure. The indicationsfor procedural sedation and analgesia included lumbar puncture and intrathecal chemotherapy (50%), bone marrow aspiration or biopsy (21.7%), and both plrocedures (28.3%). The median VAS scale during oncology procedures was 3, which were expressed by all the parentsguardians of the children treated. Adverse effects were observed in all children including nausea (30.4%), hypersalivation (26.1%), vomiting (21.7%), hallucinlation (4.2%). No child required admission to hospital and there were no serious complications. hntravenous ketamine 1 mgkg is effective for invasive procedures in children with malignancy. The use of intravenous ketamine may produce psychedelic effects in children. These adverse effects may alter the childs comfort and parental satisfaction especially in the young children.