title: Comparison of propofol-fentanyl with propofol-fentanyl-ketamine combination in pediatric patients undergoing interventional radiology procedures.
abstract: BACKGROUND
  With an increase in the frequency of interventional radiology procedures in pediatrics, there has been a corresponding increase in demand for procedural sedation to facilitate them. The purpose of our study was to compare the frequency of adverse effects, sedation level, patient recovery characteristics in pediatric patients receiving intravenous propofol fentanyl combination with or without ketamine for interventional radiology procedures. Our main hypothesis was that the addition of ketamine would decrease propofol/fentanyl associated desaturation.
  
  
  METHODS
  Sixty consenting American Society of Anesthesia physical status I-III pediatric patients undergoing interventional radiology procedures under sedation were studied according to a randomized, double-blinded, institutional review board approved protocol. Group 1 received propofol 0.5 mg.kg(-1) + fentanyl 1 microg.kg(-1) + ketamine 0.5 mg.kg(-1), and group 2 received propofol 0.5 mg.kg(-1) + fentanyl 1 microg.kg(-1) + same volume of %0.9 NaCl intravenously.
  
  
  RESULTS
  While apnea was not observed in any of the groups, there were three cases (10%) in group 1, and nine cases (30%) in group 2 with oxygen desaturation (P = 0.052). In group 1, 12 (40%) patients and, in group 2, 21 (70%) patients required supplemental propofol during the procedure (P = 0.021). There was no evidence for difference between groups in terms of other side effects except nystagmus.
  
  
  CONCLUSIONS
  In conclusion, addition of low dose ketamine to propofol-fentanyl combination decreased the risk of desaturation and it also decreased the need for supplemental propofol dosage in pediatric patients at interventional radiology procedures.
authors.affiliation: Department of Anaesthesiology and Reanimation, Hacettepe University, Sihhiye, Ankara 06100, Turkey. aydinerden@yahoo.com
authors.forename: I Aydin
authors.initials: IA
authors.lastname: Erden
authors.forename: A Gulsun
authors.initials: AG
authors.lastname: Pamuk
authors.forename: Seda B
authors.initials: SB
authors.lastname: Akinci
authors.forename: Ayhan
authors.initials: A
authors.lastname: Koseoglu
authors.forename: Ulku
authors.initials: U
authors.lastname: Aypar
mesh_terms: D000293:Adolescent; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects; D000704:Analysis of Variance; D000762:Anesthesia Recovery Period; D019162:Anesthetics, Combined / Q000008:administration & dosage* / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D016017:Odds Ratio; D010100:Oxygen / Q000097:blood; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D015642:Radiology, Interventional / Q000379:methods*; D012119:Respiration / Q000187:drug effects
chemical_list: D000700:Analgesics; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D007649:Ketamine; D010100:Oxygen; D005283:Fentanyl; D015742:Propofol