***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Our aim is to compare the haemodynamic and adverse effects of propofol versus the mixture of midazolam and ketamine as used in sedation for cardiac catheterization in children . METHODS In a prospect i ve r and omized trial , we divided patients needing sedation into 72 receiving a mixture of midazolam and ketamine and 42 receiving propofol . Their ages ranged from 6 months to 12 years , and 1 year to 16 years , respectively . We collected data relative to heart rate , mean arterial pressure , respiratory rate , peripheral saturations of oxygen , and adverse effects . We assessed cyanotic patients to establish any relationship between the haemodynamic data and peripheral arterial saturations of oxygen . RESULTS Demographic data , including age , gender , and weight , was not statistically different between the groups . In those receiving midazolam and ketamine , mean systemic arterial pressures before , and 30 minutes after , sedation were 64.3 , with st and ard deviation of 9.8 , and 62.5 , with st and ard deviation of 10.2 , millimetre of mercury ( p equals to 0.237 ) . Heart rates were 131.3 , with st and ard deviation of 13.5 , and 109.2 , with st and ard deviation of 17.3 beats per minute , ( p less than 0.001 ) whereas in those given propofol the comparable values were 71.2 , with st and ard deviation of 14.4 , and 53.6 with st and ard deviation of 9.7 millimetres of mercury ( p less than 0.001 ) , and 115.2 , with st and ard deviation of 13.6 , and 100.5 with st and ard deviation of 20.1 beats per minute ( p less than 0.01 ) , respectively . Mean systemic arterial pressures in the subgroups of cyanotic patients before and 30 minutes after sedation were 74.8 , with st and ard deviation of 14.6 , and 72.7 , with st and ard deviation of 12.4 millimetres of mercury for those receiving midazolam and ketamine ( p equals to 0.544 ) , and heart rates were 119.3 , with st and ard deviation of 12.2 , and 104.6 with st and ard deviation of 16.1 beats per minute ( p equals to 0.001 ) . In those given propofol , the comparable values were 71.1 with deviation of 15.5 and 53.9 with deviation of 9.2 millimetres of mercury ( p equals to 0.001 ) , and 126.7 with deviation of 20.8 and 107.2 with deviation of 13.5 beats per minute ( p equals to 0.001 ) , respectively . CONCLUSIONS In cyanotic children , propofol used as a sedative agent during cardiac catheterization causes a decrease in mean arterial pressure and arterial desaturation .  Ketamine produces more stable haemodynamic data in children with congenitally malformed hearts Background : The ideal anaesthetic technique for management of paediatric patients scheduled to undergo cardiac catheterisation is still not st and ardised . Aim : To compare the effects of ketamine-propofol and ketamine-dexmedetomidine combinations on hemodynamic parameters and recovery time in paediatric patients undergoing minor procedures and cardiac catheterisation under sedation for various congenital heart diseases . Material and Methods : 60 children of either sex undergoing cardiac catheterisation were r and omly assigned into two groups Dexmedetomidine-ketamine group ( DK ) and Propofol-ketamine ( PK ) of 30 patients each . All patients were premedicated with glycopyrrolate and midazolam ( 0.05mg/kg ) intravenously 5 - 10 min before anaesthetic induction . Group ' DK'received dexmedetomidineiv infusion 1 μg/kg over 10 min + ketamine1mg/kg bolus , followed by iv infusion of dexmedetomidine 0.5μg/kg/hr and of ketamine1 mg/kg/hr . Group ' PK ' received propofol 1mg/kg and ketamine 1mg/kg/hr for induction followed by iv infusion of propofol 100 μg/kg/hr and ketamine 1 mg/kg/hr for maintenance . Haemodynamic parameters and recovery time was recorded postoperatively . Statistical Analysis : Independent sample t test was used to compare the statistical significance of continuous variables of both the groups . Chi square test was used for numerical data like gender . Fischer exact test was applied for non parametric data like ketamine consumption . Results : We observed that heart rate in  dexmedetomidine ( DK ) group was significantly lower during the initial 25 mins after induction compared to the propofol ( PK ) group . Recovery was prolonged in the DK group compared to the PK group ( 40.88 vs. 22.28 min ) . Even ketamine boluses consumption was higher in DK group . Conclusion : Use of dexmedetomidine-ketamine combination is a safe alternative , without any hemodynamic orrespiratory effects during the cardiac catheterization procedure but with some delayed recovery OBJECTIVE To compare the effects of propofol and ketamine on systemic and pulmonary circulations in pediatric patients scheduled for elective cardiac catheterization . DESIGN Prospect i ve , r and omized , and blinded . SETTING University hospital . PARTICIPANTS Children ( n = 41 ) undergoing cardiac catheterization . INTERVENTIONS All children were premedicated with oral midazolam 60 minutes before the procedure . Patients were separated into 3 groups according to shunts diagnosed by transthoracic echocardiography before the catheterization procedure : patients without cardiac shunt ( Group I , n = 11 ) , left-to-right shunt ( Group II , n = 12 ) , and right-to-left shunt ( Group III , n = 18 ) . A continuous infusion of propofol ( 100 - 200 microg/kg/min ) or ketamine ( 50 - 75 microg/kg/min ) was r and omly started in all groups to obtain immobility during the procedure . Hemodynamic data , including systemic venous , pulmonary artery and vein , aortic saturations and pressures , were recorded ; Qp/Qs were calculated . The same set of data was recorded before discontinuation of infusions at the end of the procedure . MEASUREMENTS AND MAIN RESULTS After the propofol administration , in all 3 patient groups propofol infusion was associated with significant decreases in systemic mean arterial pressure . In groups with cardiac shunts ( Group II and III ) , propofol infusion significantly decreased systemic vascular resistance and increased systemic blood flow , whereas pulmonary vascular resistance and pulmonary blood flow did not change significantly . These changes result ed in decreased left-to-right shunting and increased right-to-left shunting ; the pulmonary-to-systemic flow ratio decreased significantly . On the other h and , after ketamine infusion , systemic mean arterial pressure increased significantly in all patient groups , but pulmonary mean arterial pressure , systemic vascular resistance , and pulmonary vascular resistance were unchanged . CONCLUSION In children with cardiac shunting , the principal hemodynamic effect of propofol is a decrease in systemic vascular resistance . In children with intracardiac shunting , this results in an increase in right-to-left shunting and a decrease in the ratio of pulmonary to systemic blood flow , which may lead to arterial desaturation . Ketamine did not produce these changes . The authors suggested that during cardiac catheterization in children , both the anesthesiologists and cardiologists need to know that anesthetic agents can significantly alter the hemodynamic status in children with complex congenital heart defects and affect the results of hemodynamic calculations that are important for decision-making and treatment of these patients OBJECTIVE To compare the efficiency of intravenous thiopental against intravenous ketamine-propofol combination in paediatric sedation for magnetic resonance imaging . METHODS This prospect i ve study was conducted at Ondokuz Mayis University Hospital , Samsun , Turkey , from July 1 , 2014 , to January 1 , 2015 , and comprised children aged 1 month to 12 years undergoing elective magnetic resonance imaging who were r and omly assigned to two equal groups . Group I received thiopental 3 mg/kg intravenously followed by an additional dose of thiopental 1 mg/kg to achieve a Ramsay sedation score of 4 . Group II received ketofol , a 1:1 mixture of ketamine 10 mg/mL and propofol 10 mg/mL , in a single syringe intravenously at a dose of 0.5 mg/kg at 1 minute intervals and titrated to reach a Ramsay sedation score of 4 . The groups were compared for total drug dose , time to sedation , recovery time , total sedation time , and adverse effects . Data was analysed using SPSS 22 . RESULTS There were 120 children in the study ; 60(50 % ) in each group . The time to sedation was significantly longer with ketofol than thiopental ( p<0.01 ) . The mean recovery time was significantly shorter with thiopental than with ketofol ( p<0.01 ) . Total sedation time was significantly longer with ketofol than thiopental ( p<0.01 ) . Overall , 17(28.3 % ) ketofol patients had adverse events , whereas no thiopental patients had adverse events ( p<0.0001 ) . CONCLUSIONS Thiopental had a comparable effectiveness with shorter anaesthesia inductions and recovery times than ketofol . Intravenous thiopental can be an effective and safe alternative drug in sedating children undergoing magnetic resonance imaging Background : Sedation of pediatric patients undergoing cerebral angiography is challenging . Although dexmedetomidine is used for sedation in various procedures , it has not been reported for pediatric patients undergoing cerebral angiography . This study compared the safety and efficacy of dexmedetomidine with that of propofol for cerebral angiography in pediatric patients . Material s and Methods : Sixty-two patients ( 6 - 15 years ) scheduled for elective cerebral angiography were apportioned r and omly and equally to receive either propofol or dexmedetomidine sedation . Patients in the propofol group received an initial bolus of intravenous propofol ( 1 mg/kg ) and a maintenance infusion of 100 μg/kg/min . Patients in the dexmedetomidine group received an initial bolus of intravenous dexmedetomidine ( 1 μg/kg over 10 min ) and a maintenance infusion of 1 μg/kg/h . An additional bolus of propofol 0.5 mg/kg or dexmedetomidine 0.25 μg/kg was repeated if needed . Procedure time , time to recovery and adverse events associated with sedation were recorded . Results : All cerebral angiographies were completed successfully under sedation with dexmedetomidine or propofol  . Mean cerebral angiography time was 36 ± 10 min in the propofol group and 31 ± 7 min in the dexmedetomidine group ( P = 0.047 ) . The percentage of airway events and total adverse events were significantly higher in the propofol group ( P < 0.05 ) . Heart rate decreased in the dexmedetomidine group and mean arterial pressure decreased in the propofol group ( P < 0.05 , each ) . Conclusion : Although cerebral angiography can be performed successfully under sedation with either propofol or dexmedetomidine , dexmedetomidine may be a better alternative because of fewer respiratory adverse events Purpose We aim ed to compare the efficacy and safety of midazolam plus ketamine versus fentanyl plus propofol combination administered to children undergoing upper gastrointestinal endoscopy ( UGE ) and to determine the most appropriate sedation protocol . Material s and methods This prospect i ve , r and omized , single-blind study included patients between the ages of 4 and 17 years who underwent UGE for diagnostic purpose s. Patients were divided r and omly into groups A ( midazolam – ketamine combination , n=119 ) and B ( fentanyl plus propofol combination , n=119 ) . The effectiveness of the sedation and complications during the procedure and recovery period were recorded . Results The processes started without an additional dose of the drug for 118 patients ( 99.1 % ) in group A and for 101 patients ( 84.8 % ) in group B ( P=0.001 ) . The average dose of ketamine administered to the patients in group A was 1.03±0.15 mg/kg and the average dose of propofol administered to the patients in group B was 1.46±0.55 mg/kg . None of the patients stopped the endoscopic procedure in group A , but one patient ( 0.8 % ) had to discontinue the endoscopic procedure in group B. 27 patients in group A ( 22.7 % ) and 41 patients ( 34.5 % ) in group B developed complications during the procedure ( P=0.044 ) . The rate of complications during the recovery of group A ( 1 
    Output:
    
Our meta- analysis of 30 RCTs confirmed that propofol sedation had advantages in recovery time when compared with other drugs , without excessive concerns for cardiovascular or respiratory adverse events .
Its safety profile regarding coughing , nausea or vomiting , and emergence delirium was also similar to that of other drugs .