A Clinical Study of Comparison of Dexmedetomidine and Ketamine Versus Propofol and Ketamine for Procedural Sedation in Children Undergoing Device Closure
International Journal of Anesthesia and Clinical Medicine
Volume 7, Issue 2, December 2019, Pages: 37-42
Received: Aug. 13, 2019;
Accepted: Sep. 4, 2019;
Published: Sep. 23, 2019
Views 608 Downloads 119
Sowmya Sree, Department of Anesthesiology, Care Hospitals, Hyderabad, India
Somita Christopher, Department of Anesthesiology, Care Hospitals, Hyderabad, India
Thota Venkata Sanjeev Gopal, Department of Anesthesiology, Care Hospitals, Hyderabad, India
Follow on us
This prospective, randomized trial was done to compare the effects of Dexmedetomidine-Ketamine and Propofol-Ketamine combinations on hemodynamics, sedation level, and the recovery period in paediatric patients undergoing device closure in cardiac catheterization laboratory. Sixty children undergoing device closure were divided into two groups of thirty each. The Dexmedetomidine-Ketamine group (group I, n=31) received an infusion of 1microgram/kg of Inj Dexmedetomidine over 10 minutes and 1 mg/kg of Inj Ketamine IV as a bolus for induction. The patients then received an infusion of 0.5 microgram/kg/hour of Inj Dexmedetomidine. The Propofol - Ketamine group (group II, n=29) received 1 mg/kg of Inj Propofol and 1 mg/kg of Inj Ketamine as a bolus for induction. These patients then received an infusion of100 micorgram/kg/ min of Inj Propofol. Additional doses of Inj Ketamine, 0.5 mg/kg, were administered when a patient showed discomfort in both groups. Both groups had similar additional Ketamine consumption to maintain deep sedation. The recovery time was longer in group 1 than in group 2 (13 vs 5 minutes, respectively; p <0.01). So it was concluded that both Dexmedetomidine-Ketamine and Propofol-Ketamine combinations are safe and acceptable for sedation without any hemodynamic or respiratory effects for device closure in the cardiac catheterization laboratory in children.
Dexmedetomidine, Ketamine, Propofol, Ventricular Septal Defect, Atrial Septal Defect
To cite this article
Thota Venkata Sanjeev Gopal,
A Clinical Study of Comparison of Dexmedetomidine and Ketamine Versus Propofol and Ketamine for Procedural Sedation in Children Undergoing Device Closure, International Journal of Anesthesia and Clinical Medicine.
Vol. 7, No. 2,
2019, pp. 37-42.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Saxena A. Congenital Heart Disease in India: a Status Report. Indian J Pediatr 2005; 72: 595-598.
Spies C, Cao Q-L, Hijazi ZM. Transcatheter Closure of Congenital and Acquired Septal Defects. European Heart Journal Supplements 2010; 12: E24-E34.
Lam JE, Lin EP, Alexy R, Aronson LA. Anesthesia and the Pediatric Cardiac Catheterization Suite: A Review. Paediatr Anaesth 2015; 25: 127-134.
Hanslik A, Moysich A, Laser KT, Mlczoch E, Kececioglu D, Haas NA. Percutaneous Closure of Atrial Septal Defects in Spontaneously Breathing Children under Deep Sedation: A Feasible and Safe Concept. Pediatr Cardiol 2014; 35: 215-222.
Joshi VS, Kollu SS, Sharma RM. Comparison of Dexmedetomidine and Ketamine versus Propofol and Ketamine for Procedural Sedation in Children undergoing Minor Cardiac Procedures in Cardiac Catheterization Laboratory. Ann Card Anaesth 2017; 20: 422-426.
Cote CJ, Wilson S. AMERICAN ACADEMY OF PEDIATRICS, AMERICAN ACADEMY OF PEDIATRIC DENTISTRY. Guidelines for Monitoring and Management of Pediatric Patients Before, During and After Sedation for Diagnostic and Therapeutic Procedures Pediatrics 2019; 143.
Ramsay MA, Savege TM, Simpson BR, Goodwin R. Controlled Sedation with alphaxalone-alphadolone. Br Med J 1974; 2: 656-659.
Steward DJ. A Simplified Scoring System for the Post-operative Recovery Room. Can Anaesth Soc J 1975; 22: 111-113.
Tosun Z, Akin A, Guler G, Esmaoglu A, Boyaci A. Dexmedetomidine-ketamine and Propofol-ketamine Combinations for Anesthesia in Spontaneously Breathing Pediatric patients undergoing Cardiac Catheterization. J Cardiothorac Vasc Anesth 2006; 20: 515-519.
Parvez Ali N, Kanchi M, Singh S, Prasad A, Kanase N. Dexmedetomedine-Ketamine versus Propofol-Ketamine as anaesthetic agents in Paediatric Cardiac Catheterization, JAFMC Bangladesh 2004; 1: 19-24.
Venn RM, Grounds RM. Comparison between Dexmedetomidine and Propofol for Sedation in the Intensive Care Unit: Patient and Clinician Perceptions. Br J Anaesth 2001; 87: 684-690.
Canpolat DG, Esmaoglu A, Tosun Z, Akn A, Boyaci A, Coruh A. Ketamine-propofol vs ketamine-dexmedetomidine combinations in pediatric patients undergoing burn dressing changes. J Burn Care and Res 2012; 33 (6): 718-722.
Mogahed MM, Salama ER. A Comparison of Ketamine-Dexmedetomidine versus Ketamine-Propofol for Sedation in Children during Upper Gastrointestinal Endoscopy. Journal of Anesthesia & Clinical Research 2017; 8 (11): 785.
Friesen RH, Twite MD, Nichols CS, Cardwell KA, Pan Z, Darst JR, et al. Hemodynamic response to ketamine in children with pulmonary hypertension. Paediatr Anaesth 2016; 26: 102-108.
EI Sharkawy RA. Efficacy of adding low –dose ketamine to dexmedetomidine versus low dose ketamine and propofol for conscious sedation in patients undergoing awake fiber –optic intubation. Anesth Essays Res 2019; 13: 73-8.