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Propofol Somewhat Better Than Ketamine for Painful Paediatric Procedures

Propofol with lidocaine appears to be somewhat more effective than ketamine with

midazolam and fentanyl for pediatric anaesthesia during painful critical care procedures. Propofol-lidocaine should only be used in a monitored environment, however, because of the

transient respiratory depression and hypotension associated with the regimen, say researchers at Chaim Sheba Medical Center, Tel Hashomer, Israel.

 Ninety-eight children undergoing a total of 105 procedures at an 18-bed multidisciplinary, university-affiliated paediatric critical care department were randomized to the propofol regimen or the ketamkine regimen, according to prescheduled procedure dates. Propofol was delivered by continuous infusion after a loading bolus dose and a mini-dose of lidocaine (PL). Ketamine was given as a bolus injection together with midazolam and fentanyl (KMF). Parents, nurses and physicians graded the adequacy of anesthesia, and researchers recorded the number of procedures performed, anesthetic drug doses, procedure and recovery durations, and the occurrence of side effects.

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