title: The effect of alfentanil versus ketamine on the intubation condition and hemodynamics with low-dose rocuronium in children.
abstract: OBJECTIVE
  We investigated the effect of alfentanil and ketamine on the intubation condition and hemodynamic parameters during propofol anesthesia with low-dose rocuronium in children.
  
  
  METHODS
  Fifty-four children, aged 3-9 years undergoing tonsillectomy, were randomly allocated to receive either alfentanil 20 μg/kg (alfentanil group, n = 27) or ketamine 0.5 mg/kg (ketamine group, n = 27) 1 min before anesthesia induction. Anesthesia was induced with propofol 2.5 mg/kg and rocuronium 0.3 mg/kg and maintained with propofol infusion (6 mg/kg/h). The neuromuscular relaxation was monitored, and intubation conditions, hemodynamic changes, and recovery time were assessed.
  
  
  RESULTS
  All patients were successfully intubated and there were no significant differences in the intubation conditions between alfentanil and ketamine groups. At the time of tracheal intubation, the median [inter-quartile range] twitch height was similar between two groups (37 [4-48] % in the alfentanil group vs. 29 [4-43.5] % in the ketamine group, p = 0.326).
  
  
  CONCLUSIONS
  This study showed that both ketamine 0.5 mg/kg and alfentanil 20 μg/kg provided adequate intubation condition during propofol induction with low-dose rocuronium in children. The mean arterial pressure and heart rate were higher in the ketamine group after propofol injection but they remained within the normal limit in both groups throughout the study period.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesiology and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Hee Yeon
authors.initials: HY
authors.lastname: Park
authors.forename: Yong Beom
authors.initials: YB
authors.lastname: Kim
authors.forename: Youngjun
authors.initials: Y
authors.lastname: Kwon
authors.forename: Hyun Jeong
authors.initials: HJ
authors.lastname: Kwak
mesh_terms: D000233:Adenoidectomy; D015760:Alfentanil / Q000009:adverse effects; D000732:Androstanols; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D000778:Anesthetics, Dissociative / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007649:Ketamine / Q000009:adverse effects; D008297:Male; D016343:Monitoring, Intraoperative; D003473:Neuromuscular Nondepolarizing Agents; D011229:Preanesthetic Medication; D000077123:Rocuronium; D018401:Sample Size; D014068:Tonsillectomy
chemical_list: D000732:Androstanols; D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D015760:Alfentanil; D007649:Ketamine; D000077123:Rocuronium