oral ketamine or nasal midazolam for sedation in pediatric upper gastrointestinal endoscopy

Background: there is no agreement on the route of administration and the drug of choice for providing adequate sedation for pediatric invasive procedures. objectives: we compared the utility, safety, and sedation effects of intranasal midazolam and oral ketamine. materials & methods: this double-blind clinical trial was performed on 100 children aged 2 to 14 years who were candidates for upper gastrointestinal (gi) endoscopy. patients were randomly assigned to two groups: ketamine (4 mg/kg orally) and midazolam (0.1 mg/ kg intranasal). sedation score, fear levels, children’s behavior at the time of separation from parents, and vital signs were recorded. results: higher systolic blood pressure was seen in children who received ketamine (p=0.012) and lower arterial oxygen saturation in the midazolam group (p=0.023). also, the level of sedation showed no significant difference between the groups. conclusion: based on the results, administering oral ketamine or intranasal midazolam before endoscopy induced a similar sedation score in children. also, both methods could be safe and non-invasive modalities for sedation.