Extracorporeal shock wave lithotripsy (ESWL) requires sedation in pediatric patients. Dexmedetomidine is a good drug used for sedation. The aim of this randomized prospective study was to compare the effects of dexmedetomidine-ketamine(Dex-ket) and midazolam-ketamine(M-ket) combinations on the recovery time, hemodynamic and respiratory variables and side effects in pediatric patients undergoing ESWL. Methods: Fifty pediatric patients aged between 2 and 15 years who were scheduled for elective ESWL were randomized into two groups. In Group Dex-ket we gave dexmedetomidine at 1µg/kg, given over 10 min, and a bolus of 1 mg/kg ketamine for sedation. In Group M-ket we gave midazolam at a 0.05 mg/kg bolus dose 10 min before the procedure and a 1 mg/kg bolus of ketamine. We measured and monitored the hemodynamic variables, oxygen saturation, recovery time, and the side effects. Results: In group Dex-ket four patients refused to complete the study. 21 patients in group Dex-ket and 25 patients in group M-ket completed the study. We found the recovery time [eye opening time (9.3 ± 4.5 vs. 16.2 ± 6.5 min; p<0.001), verbal response time (12.8 ± 4.9 vs. 19.2 ± 7.2 min; p<0.001), and the cooperation time (17.1 ± 5.0 vs. 23.3 ± 7.7 min; p<0.001)] to be shorter in the Dex-ket group. Also, the heart rate values were lower in the Dex-ket group at the 20th minute of the procedure (99.1 ± 19.0 vs. 118.7 ± 7.3 beats/min; p = 0.016). Conclusion: In this study we found the recovery time to be shorter with hemodynamic stability in the Dex-ket group, compared with the M-ket group. So, we can conclude that dexmedetomidine may be a good and safe alternative agent for sedation with a shorter recovery period than midazolam in the pediatric population.

Dexmedetomidine, Ketamine, Midazolam, Sedation. ESWL, Pediatrics