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March 18, 2021VIMS Health Science JournalOpen Access

Ketamine-Dexmedetomidine resulted in a significantly longer mean recovery time (44.52 minutes) compared to Ketamine-Propofol (26.74 minutes) in children undergoing minor cardiac procedures.

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Why the study?

Anesthetic management in pediatric heart disease requires safe techniques providing cardiac stability, leading researchers to evaluate ketamine-dexmedetomidine versus ketamine-propofol for sedation during minor cardiac procedures.

Does a Ketamine-Dexmedetomidine combination compared to Ketamine-Propofol improve recovery time and hemodynamic stability in pediatric patients undergoing minor cardiac procedures?

Population

80 children undergoing minor cardiac procedures in a cardiac catheterization laboratory

Comparison

Ketamine-dexmedetomidine vs ketamine-propofol

Design

Comparative analytical study

Key result

Ketamine-Dexmedetomidine resulted in a significantly longer mean recovery time (44.52 minutes) compared to Ketamine-Propofol (26.74 minutes) in children undergoing minor cardiac procedures.

Authors

RMRahul MamdeAMAmbika Mamde

Discussion

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Overview

Longer recovery with ketamine-dexmedetomidine warrants caution in pediatric cardiac sedation; leaves open optimal regimen pending higher-level trials.

Study Design

Type

RCT (n=80)

Randomization

Computer generated random allocation numbers

Multicenter

No

Structured PICO

Does a Ketamine-Dexmedetomidine combination compared to Ketamine-Propofol improve recovery time and hemodynamic stability in pediatric patients undergoing minor cardiac procedures?

P
Population
80 children aged 1 month to 10 years undergoing minor cardiac procedures in a cardiac catheterization laboratory, randomized to receive either Ketamine-Dexmedetomidine or Ketamine-Propofol for sedation.
I
Intervention
Ketamine-Dexmedetomidine (KD): dexmedetomidine IV infusion 1 μg/kg over 10 min + ketamine 1 mg/kg IV bolus for induction, then maintenance by IV infusion of 0.5 μg/kg/h of dexmedetomidine and 1 mg/kg/h of ketamine. Premedication: Glycopyrrolate (10 μg/kg) and Midazolam (50 μg/kg) IV.
C
Comparator
Ketamine-Propofol (KP): propofol 1 mg/kg and ketamine 1 mg/kg IV for induction, then maintenance by IV infusion of 100 μg/kg/min of propofol and 1 mg/kg/h of ketamine. Premedication: Glycopyrrolate (10 μg/kg) and Midazolam (50 μg/kg) IV.
O
Outcome
Recovery time and hemodynamic parameters (heart rate, respiratory rate, mean arterial pressure, SpO2)safety

Main Result

Absolute Event Rate: 44.52% vs 26.74%

p-value: p=< 0.001

In pediatric patients undergoing cardiac catheterization, a ketamine-dexmedetomidine combination provides safe sedation with reduced need for additional ketamine boluses, though it results in a longer recovery time compared to ketamine-propofol.

Limitations

  • Small sample size
  • Single-center design
  • Single-center study

Cite This Study

Mamde et al. (2021) conducted an RCT in Minor cardiac procedures (n=80). Ketamine-Dexmedetomidine vs. Ketamine-Propofol was evaluated on Mean recovery time (minutes) (p=< 0.001). Ketamine-Dexmedetomidine resulted in a significantly longer mean recovery time (44.52 minutes) compared to Ketamine-Propofol (26.74 minutes) in children undergoing minor cardiac procedures.

synapsesocial.com/papers/6a7c389e073f483584dfbe7chttps://doi.org/10.46858/vimshsj.8107
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