Comparison Effect of Midazolam Alone and Midazolam Combined with Ketamine in Bone Marrow Aspiration Pain in Children

BACKGROUND: This study aimed to compare sedative and analgesic effects of oral Midazolam and Ketamine on Bone Marrow aspiration (BMA) and Lumbar Puncture (LP). MATERIAL AND METHODS: This study was a randomized clinical trial and was performed in Amirkola Hospital in north of Iran, Babol during 2011 and 2012 .The study population consisted of 40 patients who underwent the first time of diagnostic BMA for any reason, patients were divided randomly in two groups: Oral Midazolam and combined Oral Midazolam and Ketamine. Each group consisted of patients with age of 3-7 years and over 7 years .Two methods of pain status and soothing were evaluated through CAMFORT scale checklist based on MAGNUSON National Institutes of Health Medical Center. Statistical analyses were done by Spss v.19. RESULTS: In our study, 17(42.5%) and 23(57.5%) were female and male, respectively. 28(70%) patients were aged between 3 and 7 years and 13(30%) older than 7 years. The obtained findings revealed that the difference between Midazolam sedation and combination of Midazolam and Ketamine sedation was significant (P= 0.00). The sedation in older patients was more than young patients in combination of Midazolam and Ketamine group. (P= 0.22). CONCLUSION: These findings showed that Ketamine and Midazolam combination had more efficacy than Midazolam alone for decreasing pain and sedation.