Ketofol for bone marrow aspiration and lumbar puncture in Children with ALL

Abstract Background Ketofol is usually using as a sedative drug during painful procedures now. That Provides sedation, analgesia and rapid recovery. The aim of this study was to compare the efficacy, respiratory and hemodynamic profiles, and side effects of two various combination of ketamine and propofol in patients undergoing bone marrow aspiration (BMA) and lumbar puncture (LP). Materials and Methods This randomized, double blinded study was designed to compare the quality of analgesia and side effects of intravenous ketofol in sixty boys and girls. In this study Patients received a slow bolus injection of a solution containing combination of equal amount of propofol and ketamine (1:1) (Group I) or two parts of propofol plus one part of ketamine (2:1) (Group II). Subsequent slow bolus injects to a predetermined sedation level using Ramsay Sedation Scale. Vital signs, oxygen saturation (SpO2) and incidence of any side effects were recorded. Results Ketofol was used in 49 surgical procedures in children with a median age of 5 years (1 to 10 years old). In this study there was an increase postoperative nausea, psychomimetic side effects, and increase recovery time with the largest ketamine dosage (Group I). (P-value<0.001) Conclusion The adjunctive use of smaller dose of ketamine in ketofol combination minimizes the psychomimetic side effects and shortens the recovery time. A large number of patients are required to evaluate and validate these findings.