title: The effect of ketamine on tracheal intubating conditions without neuromuscular blockade during sevoflurane induction in children.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effect of ketamine on intubating conditions for tracheal intubation during anesthesia induction with sevoflurane and alfentanil in pediatric patients.
  
  
  METHODS
  After obtaining parental consents, 50 children, aged 3-10 years, were randomly allocated into two groups to receive either i.v. ketamine 0.5 mg/kg (ketamine group, n = 25) or i.v. saline 5 ml (control saline group, n = 25). One minute after injection of the study drug (ketamine or saline), anesthesia was induced with 5% sevoflurane, followed by injection of alfentanil 10 μg/kg 1 min later. The trachea was intubated 4 min after inhalational induction of anesthesia. Acceptable intubation was defined as excellent or good intubating conditions. Mean arterial pressure (MAP) and heart rate (HR) were recorded during the induction period.
  
  
  RESULTS
  The percentage of patients with acceptable intubating conditions was higher in the ketamine group (87%) than in the control group (52%) (P = 0.0129). MAP before intubation was significantly lower in the control group than in the ketamine group (P = 0.001).
  
  
  CONCLUSIONS
  This study demonstrated that administration of ketamine 0.5 mg/kg could improve intubating conditions for tracheal intubation without neuromuscular blockade and preserve hemodynamic stability during sevoflurane inhalation induction with alfentanil in children.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Himchan Hospital, Incheon, Korea.
authors.forename: Kyong Sik
authors.initials: KS
authors.lastname: Kim
authors.forename: Hyun Jeong
authors.initials: HJ
authors.lastname: Kwak
authors.forename: Sang Kee
authors.initials: SK
authors.lastname: Min
authors.forename: Sook Young
authors.initials: SY
authors.lastname: Lee
authors.forename: Kyung Mi
authors.initials: KM
authors.lastname: Kim
authors.forename: Jong Yeop
authors.initials: JY
authors.lastname: Kim
mesh_terms: D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal; D007649:Ketamine / Q000494:pharmacology*; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D019148:Neuromuscular Blockade; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D007649:Ketamine