Kosuke Akiyama, Shohei Yamamoto, Mayumi Hayashi, Daisuke Toyama and Keiichi Isoyama
Children with hematological malignancies frequently undergo invasive procedures such as bone marrow aspiration and lumbar punctures. Although various methods of sedation are currently used for these procedures, no standard has been established to date. midazolam and ketamine (midazolam/ketamine) have been used for procedural sedation in our department. Since both of these drugs have a long half-life, sedation may persist for an excessively long time after the procedure has been completed. Propofol is an intravenously administered anesthetic that is characterized by the easy control of the depth of anesthesia and rapid recovery. Although side effects such as hypoxia and hypotension have been associated with sedation by propofol, their severities may be reduced using slow infusions. Therefore, we herein used slowly infused propofol (0.5 mg/kg over 20 seconds) for these procedures and retrospectively compared its effects with those of midazolam/ketamine. Recovery time was significantly shorter in the propofol group. Although the frequency of side effects such as hypotension was significantly higher in the propofol group, severe side effects were not observed. This may have been because propofol was slowly infused. Although the sample size is too small, the results of the present study suggest that slowly infused propofol might be effective and safe for invasive procedures on pediatric patients. A prospective study is required to further investigate appropriate methods of sedation
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