Effects of low dose ketamine before induction on propofol anesthesia for pediatric magnetic resonance imaging.
BACKGROUND
We aimed to investigate effects of low dose ketamine before induction on propofol anesthesia for children undergoing magnetic resonance imaging (MRI).


METHODS
Forty-three children aged 9 days to 7 years, undergoing elective MRI were randomly assigned to receive intravenously either a 2.5 mg x kg(-1) bolus of propofol followed by an infusion of 100 microg x g(-1) x min(-1) or a 1.5 mg x kg(-1) bolus of propofol immediately after a 0.5 mg x kg(-1) bolus of ketamine followed by an infusion of 75 microg x kg(-1) x min(-1). If a child moved during the imaging sequence, a 0.5-1 mg x kg(-1) bolus of propofol was given. Systolic and diastolic blood pressures, heart rate, peripheral oxygen saturation and respiratory rates were monitored. Apnea, the requirement for airway opening maneuvers, secretions, nausea, vomiting and movement during the imaging sequence were noted. Recovery times were also recorded.


RESULTS
Systolic blood pressure and heart rate decreased significantly in the propofol group, while blood pressure did not change and heart rate decreased less in the propofol-ketamine group. Apnea associated with desaturation was observed in three patients of the propofol group. The two groups were similar with respect to requirements for airway opening maneuvers, secretions, nausea-vomiting, movement during the imaging sequence and recovery time.


CONCLUSIONS
Intravenous administration of low dose ketamine before induction and maintenance with propofol preserves hemodynamic stability without changing the duration and the quality of recovery compared with propofol alone.
Tomatir
Erkan
E
Department of Anaesthesiology, Pamukkale University Medical Faculty, Denizli, Turkey. etomatirtr@yahoo.com
Atalay
Habip
H
Gurses
Ercan
E
Erbay
Hakan
H
Bozkurt
Pervin
P
D000293:Adolescent; D000778:Anesthetics, Dissociative / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007649:Ketamine / Q000009:adverse effects; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010100:Oxygen / Q000097:blood; D015742:Propofol / Q000009:adverse effects; D015656:Respiratory Mechanics / Q000187:drug effects
D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D007649:Ketamine; D010100:Oxygen; D015742:Propofol