One rating advantage can coexist with similar practical outcomes and slower emergence.
The 104-child trial compared intravenous S-ketamine with midazolam. Early anxiety ratings favored S-ketamine, but parent separation, mask compliance and postoperative agitation did not clearly differ. Emergence took longer in the S-ketamine group.
The dose-and-route comparison applies to selected preschool children. Statistical similarity is not formal equivalence, and a deeper sedative state is not automatically a better overall experience. Multiple outcomes should remain separate.
Report the trade-off instead of using one anxiety score as a universal success measure. Individual recovery depends on the full anesthetic course and actual observations. The study cannot determine a child’s later memory or establish that a group rating difference caused a specific perioperative event.
Source: PMC12639671, supplied full-text paper. Findings are paraphrased; forensic implications are an interpretation.
Related: Etomidate–Midazolam Versus Propofol–Ketamine in Patients With Reduced Ejection Fraction.