title: Sedation for paediatric transcatheter atrial septal defect closure: comparison of two sedation protocols.
abstract: OBJECTIVE
  This study aimed to compare the effects of dexmedetomidine-propofol and ketamine-propofol sedation on haemodynamic stability, immobility, and recovery time in children who underwent transcatheter closure of atrial septal defects.
  
  
  METHODS
  In all, 46 children scheduled for transcatheter closure of atrial septal defects (n = 46) were included. The dexmedetomidine-propofol group (n = 23) received dexmedetomidine (1 μg/kg) and propofol (1 mg/kg) for induction, followed by dexmedetomidine (0.5 μg/kg/hour) and propofol (100 μg/kg/minute) for maintenance. The ketamine-propofol group (n = 23) received ketamine (1 mg/kg) and propofol (1 mg/kg) for induction, followed by ketamine (1 mg/kg) and propofol (100 μg/kg/minute) for maintenance.
  
  
  RESULTS
  In all, 11 patients in the dexmedetomidine group (47.8%) and one patient (4.3%) in the ketamine group demonstrated a decrease ≥20% from the baseline in mean arterial pressure (p = 0.01). Heart rates decreased ≥20% from the baseline value in 10 patients (43.4%) in the dexmedetomidine group and three patients (13%) in the ketamine group (p = 0.047). Heart rate values were observed to be lower in the dexmedetomidine group throughout the procedure after the first 10 minutes. The number of patients requiring additional propofol was higher in the dexmedetomidine group (p = 0.01). The recovery times were similar in the two groups--15.86 ± 6.50 minutes in the dexmedetomidine group and 19.65 ± 8.19 minutes in the ketamine group; p = 0.09.
  
  
  CONCLUSIONS
  The ketamine-propofol combination was less likely to induce haemodynamic instability, with no significant change in recovery times, compared with the dexmedetomidine-propofol combination. The ketamine-propofol combination provided good conditions for the intervention.
authors.affiliation: 1Department of Anaesthesiology,Erciyes University Medical Faculty,Kayseri,Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Ülgey
authors.affiliation: 1Department of Anaesthesiology,Erciyes University Medical Faculty,Kayseri,Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Bayram
authors.affiliation: 1Department of Anaesthesiology,Erciyes University Medical Faculty,Kayseri,Turkey.
authors.forename: Işın
authors.initials: I
authors.lastname: Güneş
authors.affiliation: 1Department of Anaesthesiology,Erciyes University Medical Faculty,Kayseri,Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Aksu
authors.affiliation: 1Department of Anaesthesiology,Erciyes University Medical Faculty,Kayseri,Turkey.
authors.forename: Cihangir
authors.initials: C
authors.lastname: Bicer
authors.affiliation: 1Department of Anaesthesiology,Erciyes University Medical Faculty,Kayseri,Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Akin
authors.affiliation: 2Department of Pediatric Cardiology,Erciyes University Medical Faculty,Kayseri,Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Baykan
authors.affiliation: 2Department of Pediatric Cardiology,Erciyes University Medical Faculty,Kayseri,Turkey.
authors.forename: Nazmi
authors.initials: N
authors.lastname: Narin
authors.affiliation: 1Department of Anaesthesiology,Erciyes University Medical Faculty,Kayseri,Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Boyaci
mesh_terms: D000293:Adolescent; D000771:Anesthesia, Intravenous / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000008:administration & dosage*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D015742:Propofol / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D015742:Propofol