title: Is the addition of dexmedetomidine to a ketamine-propofol combination in pediatric cardiac catheterization sedation useful?
abstract: Pediatric patients undergoing cardiac catheterization usually need deep sedation. In this study, 60 children were randomly allocated to receive sedation with either a ketamine-propofol combination (KP group, n = 30) or a ketamine-propofol-dexmedetomidine combination (KPD group, n = 30). Both groups received 1 mg/kg of ketamine and 1 mg/kg of propofol for induction of sedation, and the KPD group received an additional 1 μg/kg of dexmedetomidine infusion during 5 min for induction of sedation and a maintenance infusion of 0.5 μg/kg/h. In both groups, 0.2 mg/kg of propofol was administered as a bolus to maintain a Ramsey sedation score (RSS) greater than 4 throughout the procedure. None of the patients in either group required intubation. In the KP group, one patient required mask ventilation. The chin-lift maneuver needed to be performed for eight patients in the KP group and one patient in the KPD group (p < 0.05). Adding dexmedetomidine to the ketamine-propofol combination decreased movement during the procedures. The heart rate in the KPD group was significantly lower after induction of sedation and throughout the procedure (p < 0.05). No significant differences in systolic blood pressure, diastolic blood pressure, or respiration rates were found between the two groups (p > 0.05). The mean recovery time was longer in the KP group (5.86 vs 3.13 min; p < 0.05). Adding dexmedetomidine to a ketamine-propofol combination led to a reduced need for airway intervention and to decreased movement during local anesthetic infiltration and throughout the procedure. The recovery time was shorter and hemodynamic stability good in the KPD group.
authors.affiliation: Department of Anaesthesiology, Erciyes University Medical Faculty, 38039 Kayseri, Turkey. aulgey@erciyes.edu.tr
authors.forename: Ayşe
authors.initials: A
authors.lastname: Ülgey
authors.forename: Recep
authors.initials: R
authors.lastname: Aksu
authors.forename: Cihangir
authors.initials: C
authors.lastname: Bicer
authors.forename: Aynur
authors.initials: A
authors.lastname: Akin
authors.forename: Resul
authors.initials: R
authors.lastname: Altuntaş
authors.forename: Aliye
authors.initials: A
authors.lastname: Esmaoğlu
authors.forename: Ali
authors.initials: A
authors.lastname: Baykan
authors.forename: Adem
authors.initials: A
authors.lastname: Boyaci
mesh_terms: D000778:Anesthetics, Dissociative / Q000008:administration & dosage*; D006328:Cardiac Catheterization; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D007649:Ketamine / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D018709:Statistics, Nonparametric
chemical_list: D000778:Anesthetics, Dissociative; D004338:Drug Combinations; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D007649:Ketamine; D015742:Propofol