Effect of Ketamine-Atropine-Midazolam Versus Dexmedetomidine-Atropine-Midazolam on Sedation Level in Children Undergoing Bone Marrow Biopsy: A Randomized Double-Blind Clinical Trial
| Author | Reza Aminnejad | en |
| Author | Fateme Razavinia | en |
| Author | Mohammad Saeidi | en |
| Author | Seyed Kamal Eshagh Hosaini | en |
| Author | Alireza Bahrululoom | en |
| Author | Mostafa Vahedian | en |
| Author | Mohammad Amin Afshani | en |
| Orcid | Reza Aminnejad [0000-0003-0439-0440] | en |
| Orcid | Mohammad Saeidi [0000-0002-5987-9932] | en |
| Orcid | Seyed Kamal Eshagh Hosaini [0000-0002-0176-4884] | en |
| Orcid | Mostafa Vahedian [0000-0002-4271-6387] | en |
| Issued Date | 2026-02-28 | en |
| Abstract | Background: Bone marrow aspiration and biopsy are essential diagnostic procedures in pediatric hematology, yet often cause considerable discomfort. Safe and effective oral sedation regimens are required to optimize procedural tolerance. Objectives: This study compared the effects of ketamine-atropine-midazolam (KAM) versus dexmedetomidine-atropine-midazolam (DAM) on sedation quality and physiological stability in children undergoing bone marrow biopsy (BMB). Methods: In this double‑blind clinical trial, 72 children scheduled for BMB were randomly allocated to two equal groups. Forty‑five minutes before the procedure, the KAM group received ketamine (4 mg/kg), atropine (0.1 mg/kg), and midazolam (0.5 mg/kg); the DAM group received dexmedetomidine (8 µg/kg), atropine (0.1 mg/kg), and midazolam (0.5 mg/kg). Vital signs and sedation scores [Ramsay Sedation Scale (RSS) and Richmond Agitation-Sedation Scale (RASS)] were recorded at baseline, 2, 5, 10, and 45 minutes after drug administration. Data were analyzed with SPSS v22 using appropriate statistical tests. Results: Demographic characteristics were similar between groups. Mean Body Mass Index (BMI) values did not differ significantly (P = 0.32). There were no significant intergroup differences in blood pressure, respiratory rate, temperature, or oxygen saturation. Pulse rate was lower in KAM at 5 - 45 minutes (P < 0.01). Sedation induction was faster, and specialists’ satisfaction higher in KAM (both P < 0.01). Mean Ramsay and RASS scores were significantly greater in KAM (4.97 vs. 3.08; 8.41 vs. 5.80). Conclusions: The KAM regimen provided deeper and more stable sedation with comparable physiological safety, suggesting it as an effective alternative for pediatric bone marrow procedures. This study was limited by its single-center design and the relatively small sample size, which may affect the generalizability of results. | en |
| DOI | https://doi.org/10.5812/jcp-167231 | en |
| Keyword | Ketamine | en |
| Keyword | Dexmedetomidine | en |
| Keyword | Sedation | en |
| Keyword | Oncology | en |
| Keyword | Pediatrics | en |
| Publisher | Brieflands | en |
| Title | Effect of Ketamine-Atropine-Midazolam Versus Dexmedetomidine-Atropine-Midazolam on Sedation Level in Children Undergoing Bone Marrow Biopsy: A Randomized Double-Blind Clinical Trial | en |
| Type | Research Article | en |
Files
Original bundle
1 - 1 of 1
Loading...
- Name:
- jcp-17-1-167231-publish-pdf.pdf
- Size:
- 177.7 KB
- Format:
- Adobe Portable Document Format
- Description:
- Article/s PDF