Comparison Effect of Intravenous Ketamine with Sufentanil for Pain Relief during Painful Procedures in Children with Leukemia

Background: Children with leukemia would go through different diagnostic and therapeutic procedures during their process of their disease, including lumbar puncture and bone marrow aspiration; these procedures are usually associated with pain and stress. The aim of the present study was to compare the effect of two combinations of Propofol-Ketamine and Propofol-Sufentanil on sedation and analgesia during painful procedures in children with acute lymphoblastic leukemia. Methods: In a randomized, double-blind clinical trial, 70 children with acute lymphoblastic leukemia undergoing painful procedures were randomly allocated into two parallel groups and took Intravenous Ketamine (1 mg/kg/dose) or Sufentanil (0.5 mcg/kg/dose). Both groups received Intravenous propofol (1.2mg/kg). Hemodynamic variables and analgesic effect were compared between groups. Results: There was no significant difference between the two groups in terms of the changes in vital signs at the time before, during and after the procedure. But, the incidence of patient’s movements and the need for repeated propofol boluses was significantly lower in the Ketamine group compared to the Sufentanil group (P: 0.008). Conclusion: Ketamine is a good choice for conducting painful procedures on children with acute lymphoblastic leukemia. Ketamine might be a good option for pain relief during painful procedures such as intrathecal injection, bone marrow aspiration. Ketamine could also be more effective in controlling the movements and decreasing the need for repeating the drug dosage compared to the Sufentanil.