Total intravenous anesthesia with ketamine for pediatric interventional cardiac procedures.
OBJECTIVE
To evaluate the safety and efficacy of ketamine in pediatric patients undergoing interventional cardiac procedures.


METHODS
A retrospective clinical study.


METHODS
A single, tertiary referral center.


METHODS
Patients (n = 107) undergoing interventional cardiac procedures between July 1996 and July 1998.


METHODS
Each patient received a bolus of ketamine, 1 mg/kg intravenously, followed by an infusion of 50 to 75 microg/kg/min for the duration of the procedure.


RESULTS
Hemodynamic and respiratory parameters were noted. All patients were breathing spontaneously. Average infusion dose of ketamine was 51.40+/-3.54 microg/kg/min (mean +/- standard deviation). Increases in heart rate and mean arterial pressure by more than 20% from baseline values were seen in 10 and 9 patients, respectively. Transient apnea and excessive salivation were seen in two patients each. Excessive movement of extremities was seen in six patients. There were no episodes of unpleasant dreams or hallucinations. There were two deaths (1.9%) related to the interventional procedures.


CONCLUSIONS
The technique described is a simple, safe, and effective method for anesthetizing children in the cardiac catheterization laboratory for interventional procedures.
Singh
A
A
Department of Anesthesiology, Escorts Heart Institute & Research Centre, New Delhi, India.
Girotra
S
S
Mehta
Y
Y
Radhakrishnan
S
S
Shrivastava
S
S
D000293:Adolescent; D000771:Anesthesia, Intravenous; D000778:Anesthetics, Dissociative / Q000008:administration & dosage*; D002404:Catheterization / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D006330:Heart Defects, Congenital / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D012119:Respiration; D012189:Retrospective Studies
D000778:Anesthetics, Dissociative; D007649:Ketamine