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01-01-2021 | Propofol | Original Article

Adjuvant lidocaine to a propofol-ketamine-based sedation regimen for bone marrow aspirates and biopsy in the pediatric population

Authors: Jeffrey S. Yu, Ryan Louer, Riad Lutfi, Samer Abu-Sultaneh, Mouhammad Yabrodi, Janine Zee-Cheng, Kamal Abulebda

Published in: European Journal of Pediatrics | Issue 1/2021

Abstract

Pediatric patients with hematological malignancies repeatedly undergo painful bone marrow aspirates and biopsies (BMABs) in routine care. No standard sedation regimen has been established. This study evaluated the addition of injected local lidocaine to a propofol-ketamine sedation for BMAB and its effects on propofol dosing, safety, and efficacy. A retrospective analysis of children undergoing BMAB with propofol-ketamine with (PK+L) and without (PK-only) the injection of local lidocaine. Patients were matched through propensity probability scores. To measure efficacy, dosing, procedure length, and recovery time were evaluated. To assess safety, adverse and serious events were recorded. As an indirect measurement of analgesia, changes in heart rate and blood pressure were analyzed. Of the 420 encounters included, 188 matched pairs (376 patients) were analyzed. Patient demographics were comparable. The median dose of propofol was not significantly different between both groups. The incidence of adverse events was similar. There were no significant differences in the changes in heart rate and blood pressure with sedation between groups.

Conclusion: This study suggests that the addition of local lidocaine injection to a propofol-ketamine sedation for BMAB pediatric patients does not affect the propofol dose, safety, or efficacy properties of the regimen.

What is Known: •Although propofol is commonly used, there is no standard sedation regimen for pediatric patients undergoing bone marrow aspiration and biopsy. •Local lidocaine is used in analgesia in the adults undergoing the same procedure.
What is New: •Local lidocaine adjuvant to propofol-ketamine sedation does not affect propofol dosing, the safety of efficacy properties of the regimen in the pediatric population.

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Title: Adjuvant lidocaine to a propofol-ketamine-based sedation regimen for bone marrow aspirates and biopsy in the pediatric population
Authors: Jeffrey S. Yu
Ryan Louer
Riad Lutfi
Samer Abu-Sultaneh
Mouhammad Yabrodi
Janine Zee-Cheng
Kamal Abulebda
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Keywords: Propofol
Ketamine
Published in: European Journal of Pediatrics / Issue 1/2021
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-020-03713-5

At a glance: The STEP trials

Springer Medicine

Adjuvant lidocaine to a propofol-ketamine-based sedation regimen for bone marrow aspirates and biopsy in the pediatric population

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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