Comparative study between Dexmedetomidine-Ketamine and Propofol-Ketamine Combinations for Anesthesia in Spontaneously Breathing Pediatric Patients Undergoing Cardiac Catheterization

Abstract

Introduction: Sedation for pediatric cardiac catheterization is a common requirement in many institutions. The goals of the anesthetic management during cardiac catheterization are adequate analgesia, sedation, immobility, and cardiovascular stability(Cravero et al, 2006). Ketamine has potential advantages includeexcellent sedation and analgesia and maintenance of airwayreflexes and respiratory drive. Also, it preserves cardiac function(Williams et al, 2007). Propofol has a predictable onset of action, a short half-life with a rapid recovery time, and is easily titratable. However, propofol is associated with profound respiratory depression, and no analgesic effect(Ewen et al, 1995). Dexmedetomidine is a highly selevtive α2 adrenoceptor agonist with more specificity for the receptor compared to clonidine, approved by FDA in 1999. It provides excellent sedation and analgesia with minimal respiratory depression (Bhana et al, 2000). Aim of work: This study aimed to compare between dexmedetomidine-ketamine and propofol-ketamine combinations in pediatric patients undergoing cardiac catheterization. Patients and methods: After local ethical committee approval an obtained consent from the parents, 44 acyanotic pediatric patients, aged 4 months to 16 years with ASA II and III, analyzed with the chi-square test.