Dexmedetomidine-Ketamine Sedation in a Patient With Dilated Cardiomyopathy

Abstract

Sedative and analgesic medications may impact physiologic function resulting in adverse effects especially in patients with co-morbid diseases. We present the successful use of a combination of dexmedetomidine and ketamine to provide sedation and analgesia in a 9-month-old patient with dilated cardiomyopathy undergoing hemodynamic cardiac catheterization with angiography. Co-morbid conditions included depressed myocardial function, hypertension, right renal artery agenesis, and narrowing of the abdominal aorta. A combination of dexmedetomidine and ketamine was used to provide procedural sedation while maintaining spontaneous ventilation. A review of previously published reports of dexmedetomidine and ketamine for procedural sedation is reviewed and the potential efficacy of this combination for procedural sedation in patients with depressed myocardial function is presented. J Med Cases. 2017;8(10):293-296 doi: https://doi.org/10.14740/jmc2851w