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J Med Assoc Thai. 2015 Apr;98(4):358-64.

The clinical effect of fentanyl in comparison with ketamine in analgesic effect for oncology procedures in children: a randomized, double-blinded, crossover trial.

Abstract

BACKGROUND:

Children often require relief of pain and anxiety when undergoing painful procedures.

OBJECTIVE:

To determine the differences by comparing fentanyl and ketamine used in cancer-diagnosed children undergoing painful procedures.

MATERIAL AND METHOD:

A randomized, double-blinded, crossover trial was conducted with 55 children undergoing painful procedures (intrathecal chemotherapy and/or bone marrow aspiration/biopsy). Patients were randomly assigned in a double-blinded fashion to receive either intravenous fentanyl or ketamine at 1 mcg/kg/dose and 1 mg/kg/dose, respectively. The result in effectiveness of the drug was measured using three parameters, 1) satisfaction score ranging from 0 to 10, 2) perception of procedural pain using FLACC scale, Wong-Baker FACES Pain Rating Scale and Visual Analog Scale, and 3) the frequency of vomiting nausea score.

RESULTS:

The satisfaction amongpatients receiving fentanyl was significantly greater than ketamine (p = 0.007). In addition, both painful and nausea/vomiting were significantly decreased in the patients receiving fentanyl (p = 0.002 and p < 0.001, respectively). No serious complications were observed

CONCLUSION:

This study demonstrated that intravenous fentanyl generated a superior clinical effect in satisfaction, decreased pain and nausea/vomiting, and showed no significant side-effects over ketamine. Fentanyl may also be recommended as a reasonable option before undergoing oncology procedures in children with cancer.

PMID:
25958710
[Indexed for MEDLINE]

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