Propofol-ketamine mixture for anesthesia in pediatric patients undergoing cardiac catheterization.
OBJECTIVE
To evaluate the safety of a propofol-ketamine mixture to induce and maintain anesthesia in spontaneously breathing pediatric patents during cardiac catheterization.


METHODS
Prospective clinical study.


METHODS
Departments of Cardiothoracic Surgery, Anesthesiology, and Pediatric Anesthesiology in a university hospital.


METHODS
Forty-five children aged 6 months to 16 years with ASA grade II to III undergoing cardiac catheterization.


METHODS
Continuous intravenous infusion of a mixture of propofol (4 mg/mL) and ketamine (2 mg/mL) with spontaneous ventilation. The infusion rate was changed and additional boluses of propofol or/and ketamine were given as needed. Hemodynamic, respiratory, and other variables were recorded during the procedure and recovery.


RESULTS
Mean dose of ketamine was 26 +/- 8.3 microg/kg/min and of propofol, 68.3 +/- 21.7 microg/kg/min. Changes in heart rate and mean arterial pressure of more than 20% from baseline were observed in 4 and 5 patients, respectively. A transient reduction in oxygen saturation because of hypoventilation was observed in 3 patients and responded to oxygen administration and manual assisted ventilation. No other complications were observed.


CONCLUSIONS
The propofol-ketamine mixture is a safe, practical alternative for general anesthesia in pediatric patients undergoing cardiac catheterization.
Kogan
Alexander
A
Department of Cardiothoracic Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel. akogan@clalit.org.il
Efrat
Rachel
R
Katz
Jacob
J
Vidne
Bernardo A
BA
D000293:Adolescent; D000700:Analgesics / Q000009:adverse effects*; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000187:drug effects; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000009:adverse effects*; D007902:Length of Stay / Q000706:statistics & numerical data; D015742:Propofol / Q000009:adverse effects*; D011446:Prospective Studies; D013997:Time Factors
D000700:Analgesics; D018686:Anesthetics, Intravenous; D004338:Drug Combinations; D007649:Ketamine; D015742:Propofol