Dexmedetomidine-ketamine and propofol-ketamine combinations for anesthesia in spontaneously breathing pediatric patients undergoing cardiac catheterization.
OBJECTIVE
The purpose of this study was to compare the effects of dexmedetomidine-ketamine and propofol-ketamine combinations on hemodynamics, sedation level, and the recovery period in pediatric patients undergoing cardiac catheterization.


METHODS
Prospective, randomized trial.


METHODS
University hospital.


METHODS
Children (n = 44) undergoing cardiac catheterization.


METHODS
The dexmedetomidine plus ketamine group (group 1, n = 22) received an infusion over 10 minutes of 1 microg/kg of dexmedetomidine and ketamine, 1 mg/kg, as a bolus, for induction. The patients then received an infusion of 0.7 microg/kg/h of dexmedetomidine and 1 mg/kg/h of ketamine for maintenance. The propofol plus ketamine group (group 2, n = 22) received 1 mg/kg of propofol and 1 mg/kg of ketamine for induction. The patients received 100 microg/kg/min of propofol and 1 mg/kg/h of ketamine by infusion for maintenance. Additional doses of ketamine, 1 mg/kg, were administered when a patient showed discomfort in both groups.


RESULTS
Hemodynamic data, respiratory rate, bispectral index, and sedation scores were recorded after induction and every 15 minutes thereafter. The time to reach a Steward recovery score of 6 was recorded. The heart rate in group 1 was significantly lower (average 10-20 beats/min) than group 2 after induction and throughout the procedure. Ketamine consumption in group 1 was significantly more than in group 2 (2.03 mg/kg/h v 1.25 mg/kg/h) for maintenance (p < 0.01). The recovery time was also longer in group 1 than in group 2 (49.54 v 23.16 minutes, respectively; p < 0.01).


CONCLUSIONS
The dexmedetomidine-ketamine combination was not superior to a propofol-ketamine combination because of insufficient sedation and analgesia and a longer recovery time.
Tosun
Zeynep
Z
Department of Anesthesiology and Reanimation, Erciyes University School of Medicine, Kayseri, Turkey. zeynept@erciyes.edu.tr
Akin
Aynur
A
Guler
Gulen
G
Esmaoglu
Aliye
A
Boyaci
Adem
A
D000762:Anesthesia Recovery Period; D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004569:Electroencephalography; D005260:Female; D006339:Heart Rate; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D015742:Propofol / Q000008:administration & dosage*; D012119:Respiration
D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D007649:Ketamine; D015742:Propofol