A Clinical Study of Comparison of Dexmedetomidine and Ketamine Versus Propofol and Ketamine for Procedural Sedation in Children Undergoing Device Closure

Abstract

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.