Key result
Intranasal administration of ketamine, midazolam, or their combination resulted in similar mean sedation scores, though the combination regimen achieved adequate sedation faster.
Why the study?
The study aimed to determine the effectiveness and safety of using intranasal ketamine, midazolam, or their combination for sedation during pediatric computed tomography.
Does intranasal ketamine, midazolam, or their combination provide effective and safe sedation in pediatric patients undergoing computed tomography?
RCT (n=60)
Double-blind
Simple balloting without replacement
No
Does intranasal ketamine, midazolam, or their combination provide effective and safe sedation in pediatric patients undergoing computed tomography?
The intranasal combination of ketamine and midazolam provides rapid, effective, and safe sedation for pediatric patients undergoing CT scans, with fewer sedation failures than either agent alone.
Answers are grounded in this paper and cite their sources.
Favors intranasal combination for faster sedation onset; extends RCT options for non-IV regimens in practice and trials.
ObjectiveThis study aimed to determine the effectiveness and safety of using intranasal ketamine, midazolam, or their combination for sedation during pediatric computed tomography.MethodIn this randomized, double-blind study, 60 children aged ≤2.5 years who were scheduled to undergo computed tomography were allocated into the following three groups: Group K (ketamine 10 mg/kg), Group M (midazolam 0.2 mg/kg), and Group C (ketamine 7.5 mg/kg + midazolam 0.1 mg/kg). In all cases, the drugs were administered intranasally. Sedation parameters were assessed.ResultOf the 60 randomized participants, 10 were excluded due to failed sedation. Data from 16 (Group M), 14 (Group K), and 20 (Group C) participants were analyzed. The mean sedation scores were similar: Groups K (2.86 ± 0.38), M (2.63 ± 0.74), and C (2.70 ± 0.68) (p = 0.579). Time to adequate sedation was shortest in Group C (22 ± 9 min; p = 0.022). Recovery was fastest in Group M (63 ± 25 min; p = 0.007). Discharge times differed significantly (p = 0.036) among the groups, with Group M exhibiting a discharge time of 92 ± 29 min. Group C had superior parental separation scores compared with the other groups (p = 0.035).ConclusionIntranasal administration of ketamine, midazolam, or their combination is safe and effective for inducing sedation during computed tomography in pediatric patients with minimal side effects.
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Annan et al. (2025) conducted an RCT in Pediatric patients requiring sedation for computed tomography (n=60). Intranasal ketamine, midazolam, or their combination vs. Active comparators (3-arm trial) was evaluated on Mean sedation score (Pediatric Sedation State Scale) (p=0.579). Intranasal administration of ketamine, midazolam, or their combination resulted in similar mean sedation scores, though the combination regimen achieved adequate sedation faster.
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