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Thanks to all,
Medazolam is good to keep child sedated but there is the risk of paradoxical 
excitation and decrease respiratory efforts after procedure.

ketamine has analgesic  and amnesic effect.
Having no problem with doing the procedure doesn't mean the child and 
parents are satisfied about it.
We had instance of parents refusing to continue the procedure because of 
child's continous crying.
ketamine will be the drug of choice to  keep everybody happy.

In Advanced PEM conference in NY last year there was a talk that argued 
about the scientific basis of not using ketamine for head injury pt.


Saeed Alobeidani
Royal hospital

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