Mixed Sedation Method Is Safe for Children

A new research carried out by Drs. Amit Shah, Gregory Mosdossy and Michael Rieder of the Schulich School of Medicine & Dentistry at The University of Western Ontario and Lawson Health Research Institute, confirms what doctors already suspected – combining ketamine and propofol for sedating children before surgery allows them to recover faster and suffer less from side effects.

When a child needs a painful procedure in the emergency department, having an appropriate procedural sedation and analgesia is crucial.

In children's health care, the combination of the two common drugs – ketamine and propofol, used in emergency departments has become very popular.

Still, no one knew for sure if combining the two was better for children, rather than using either one alone, until recently.

The study that confirmed this common practice, involved 136 children, who were treated at the London Health Sciences Center’s Children's Hospital.

Even though previous studies have speculated the advantages of this drug mix, this is the first large study that focuses on the use of ketamine-propofol for children in the Pediatric Emergency Department.

Dr Shah said that this “study found that ketamine-propofol is an effective combination for pediatric procedural sedation, providing a slightly shorter total sedation time than ketamine alone, with less adverse events and higher satisfaction scores.

“We believe this study provides evidence for a safe and effective alternative sedation regimen for children in the Emergency Department and may lead to a change in sedation practices in other hospitals,” he added.

Ketamine, is a drug that is known to be safe and effective for procedural sedation and analgesia, however, one of its side effects is vomiting.

As for propofol it is linked to a dose-dependent risk of respiratory depression, even if its side effects are less serious.

In this case, the bet on the combination of the two, with a decrease of dosage for both, won, as it reduced the side effects and still represented a safe and effective analgesia.