Background: The use of ketamine in interventional radiology procedures remains historically unfavored
due to the potential hallucination. Ketamine is known to induce dissociative anesthesia
while maintaining airways and hemodynamics. The aim of this study is to assess the
safety and effectiveness of moderate sedation using simultaneous administration of
a mixture of ketamine and midazolam in interventional radiology procedures.
Materials and Methods: A retrospective cohort study was conducted of 74 consecutive patients (59.5% females)
who underwent a variety of vascular and interventional procedures in a tertiary care
center. The mean age was 42.2 ± 16.6 (range, 13–80). Out of 74 patients, 15 had American
Society of Anesthesiologists score 1 (20.3%), 51 (68.9%) with score 2, and 8 (10.8%)
with score 3.
Result: The mean dosage of ketamine was 33.9 ± 18.9 mg (range, 8–100). The mean dosage of
midazolam was 1.6 (range, 0.2–5). Five patients required additional fentanyl for analgesia.
The mean systolic blood pressure (BP) at baseline was 127.3 ± 22.1, the mean systolic
BP during the procedure was 143.1 ± 22.1, and the mean systolic BP during recovery
was 133.1 ± 18.3. The mean diastolic BP at baseline was 71.2 ± 12.1, the mean diastolic
BP during a procedure was 81.1 ± 12.9, and the mean diastolic BP during recovery was
74.8 ± 12.6. Aldrete score was recorded in 72 of the patients with a mean of 9.7 ± 0.5
(range, 7–10). The Mean lowest Ramsay score during the procedure was 1.9 ± 0.5 (range,
1–3) and the mean highest Ramsay score during the procedure was 2.7 ± 0.7 (range,
2–5). Side effects were observed in five patients, self-limiting hallucinations in
four patients (5.4%), and vomiting in one patient (1.4%). No cardiovascular or respiratory
complications were encountered
Conclusions: The mixture of ketamine and midazolam appears to be effective in providing adequate
moderate sedation and analgesia during interventional procedures with a low rate of
side effects.
