title: Propofol-ketamine or propofol-remifentanil for deep sedation and analgesia in pediatric patients undergoing burn dressing changes: a randomized clinical trial.
abstract: OBJECTIVE
  In this study, we compared the propofol-ketamine and propofol-remifentanil combinations for deep sedation and analgesia during pediatric burn wound dressing changes.
  
  
  METHODS
  Fifty pediatric patients aged 12-36 months, undergoing burn wound dressing changes, were randomly assigned to receive propofol-remifentanil (group PR) or propofol-ketamine (group PK) for deep sedation and analgesia. Patients in the group PR received 2 mg·kg(-1) propofol and 0.1 μg·kg(-1) remifentanil, and 0.05 μg·kg(-1) ·min(-1) remifentanil was infused continuously until the end of the procedure. Patients in the group PK received 2 mg·kg(-1) propofol and 1 mg·kg(-1) ketamine, and the same volume of isotonic saline was infused continuously until the end of the procedure. Additional propofol with remifentanil or ketamine was administered when required. Hemodynamic variables, drug requirements, occurrence of patient movement, surgeon's satisfaction score, recovery time, and the incidence of adverse events were recorded throughout the procedure and recovery.
  
  
  RESULTS
  Recovery time was significantly shorter in the group PR compared to that in the group PK (10.3 [9.1-11.5] min vs 22.5 [20.3-25.6] min, median [interquartile range], respectively; P < 0.001). No significant hypotension or bradycardia occurred throughout the procedure. No significant differences were observed in terms of drug requirements, occurrence of patient movement, surgeon's satisfaction, incidence of respiratory depression, hypoxia, or nausea and vomiting
  
  
  CONCLUSIONS
  The combinations of propofol-ketamine and propofol-remifentanil were effective for sedation and analgesia in pediatric patients undergoing burn dressing changes, but the propofol-remifentanil combination provided faster recovery compared to the propofol-ketamine combination.
authors.affiliation: Department of Anesthesiology & Pain Medicine, Bestian Burn Care Center, Seoul, Korea.
authors.forename: Tai-Kyung
authors.initials: TK
authors.lastname: Seol
authors.forename: Jin-Kyu
authors.initials: JK
authors.lastname: Lim
authors.forename: Eun-Kyung
authors.initials: EK
authors.lastname: Yoo
authors.forename: Seong-Won
authors.initials: SW
authors.lastname: Min
authors.forename: Chong-Soo
authors.initials: CS
authors.lastname: Kim
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Hwang
mesh_terms: D000698:Analgesia / Q000379:methods*; D000762:Anesthesia Recovery Period; D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D001458:Bandages; D002056:Burns / Q000150:complications*; D002675:Child, Preschool; D054810:Deep Sedation / Q000379:methods*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D007223:Infant; D007649:Ketamine; D008297:Male; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D059408:Pain Management / Q000379:methods; D010880:Piperidines; D015742:Propofol; D000077208:Remifentanil; D016896:Treatment Outcome
chemical_list: D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D010880:Piperidines; D007649:Ketamine; D000077208:Remifentanil; D015742:Propofol
keywords: adverse events; complications; anesthetic; burns; intravenous agents; drugs