Comparison of dexmedetomidine versus propofol for maintenance of anesthesia during invasive procedures in pediatric oncology patients: a controlled randomized double-blind study

Abstract

Background We designed our study to compare the effects of dexmedetomidine infusion versus propofol infusion on perioperative hemodynamics, sedation, pain, and recovery scores for invasive procedures in pediatric oncology patients. Patients and methods Forty children, 6-12 years of age, ASA I or II with hematological cancer, were randomized to receive either dexmedetomidine or propofol infusion during anesthesia for diagnostic or prognostic short-duration procedures. All patients received ketamine 0.5 mg/kg intravenously before the start of the procedure. Increments of ketamine (0.33 mg/kg, intravenously) was given to maintain the sedation score 5-6 using the Ramsay score. Routine vital signs, oxygen saturation, time for induction of sedation, total incremental doses of ketamine, time for spontaneous eye opening after stopping the infusion, recovery excitation score, and pain score were recorded. Results Induction and recovery times were significantly shorter in the propofol/ketamine group. Although there was significant difference in heart rates between the two groups with lower rates for the dexmedetomidine/ketamine group, patients in the dexmedetomidine/ketamine group had significant lesser excitation score and lower pain score than patients in the propofol/ketamine group. Conclusion Dexmedetomidine/ketamine infusion provides hemodynamic stability, lower recovery excitation, and pain scores, although recovery time is prolonged when compared with propofol/ketamine infusion in invasive procedures in pediatric oncology patients. Thus, it represents an alternative sedoanalgesic choice for this population.