Premedication for LISA/ MIST

[NHowold]

16 hours ago, kbarrington said:

We just reviewed our experience with Ketamine, used in 100% of our LISA since we introduced the protocol. Occasional apnea requiring PPV, but most tolerate it very well.

What dosage do you use? 0.25 or 0.5 mg/kg? 

[Stefan Johansson]

17 hours ago, kbarrington said:

We just reviewed our experience with Ketamine, used in 100% of our LISA since we introduced the protocol. Occasional apnea requiring PPV, but most tolerate it very well.

IMHO ketamine seems like a very good choice. We use fentanyl and my experience is not the best, it usually works but sometimes we do see thorax rigidity or insufficient analgesia.

Do you also premed with atropine? Have you done some kind of systematic discomfort scoring etc, ie are you happy with the analgesia?

[kbarrington]

We give atropine as a routine, then 1 mg/kg of ketamine, a few babies have a supplemental 0.5 mg/kg dose. It is so difficult to score pain during an invasive procedure with several people in the room and at least 2 at the head of the baby. I'm reasonably happy with the analgesia given that limitation.