THE EFFECTS OF DIFFERENT DOSE KETAMINE ON PROPOFOL SEDATION FOR INFANTS AND CHILDREN UNDERGOING AMBULATORY MAGNETIC RESONANCE IMAGING

Year 2014, Volume: 16 Issue: 3, 13 - 17, 01.12.2014

Fatih Doğu Geyik Tülin Akarsu Ayazoğlu Orhan Akman Aynur Özensoy Kartal Koşuyolu High Speciality Muhittin Çalım

Abstract

Objective: The aim of this study was to evaluate the efficiency and effectiveness of the sedation practice, recovery time, and adverse event profile and total propofol consumption combined propofol infusion plus bolus propofol with different doses of ketamine -propofol combinations for infants and children sedation undergoing ambulatory magnetic resonance imaging. Methods: After obtaining approval from the University Ethics Committee, This double-blind, randomized trial enrolled American Society of Anesthesiology (ASA) Class I - III patients, aged 1 month to 12 years requiring MRI under deep sedation. One hundred and forty two patients were included in the study and were divided into 4 groups, prospectively. Premedication consisted of intranasal midazolam 0.5 mg/ kg over six month children. Group I received 1 mg/kg propofol intravenously (IV), bolus followed by a 100 μq/kg/min infusion. Group II, III, IV received IV ketamine bolus of 0.5mg/ kg, 1mg/kg and 1.5mg/kg respectively and then patients received an infusion of a solution containing propofol 100 μq/kg/min augmented with additional propofol boluses as needed. Blood pressure, heart rate, Ramsey sedation scores, oxygen saturation and end-tidal CO2 levels were recorded once every five minutes. Duration of the procedure, total amount of propofol used, time until Aldrete scores reached 9 and additional propofol doses needed were also recorded, as were complications like agitation, desaturation, bradycardia and hypotension. Results: There were no differences between the demographic properties of the groups. Twentyfive, 65, 70 and 75th minute heart rates were higher in ketamine groups when compared to Group 1, the difference was significant (p

Keywords

Propofol, ketamine, MRI sedation, children, outpatient (day-case)

Bebek ve Çocuk Hastalarda Ambulatuar Manyetik Rezonans Görüntüleme Uygulamalarında Propofol Sedasyonuna Farklı Doz Ketamin Eklenmesinin Etkileri

Abstract

Amaç: Çalışmanın amacı, manyetik rezonans görüntüleme uygulamalarında bebek ve çocukhastalarda kombine propofol infüzyon + bolus propofol ile farklı doz ketamin-propofolkombinasyonunun, sedasyon uygulaması , derlenme süresi ve yan etki profili ile toplampropofol tüketimi, verimliliğini ve etkinliğini değerlendirmektir. Yöntem: Çalışmaya etik kurul onayı alındıktan sonra anestezi altında manyetik rezonansgörüntüleme işlemi yapılacak olan 1 ay – 12 yaş arası, ASA I-III 142 hasta dahil edildi ve 4gruba ayrıldı. 6 aydan büyük çocuklara 0,5 mg/kg dan intranazal midazolam ile premedikasyonyapılmıştır. Grup 1 olgulara 1 mg/kg’dan bolus propofol uygulandıktan sonra100 μq/kg/dk danpropofol infüzyonu başlandı. Grup 2; 0,5 mg/kg dan bolus ketamin; Grup 3; 1 mg/kg’danketamin Grup 4; 1,5 mg/kg’dan bolus ketamin’i takiben da 100 μq/kg/dk dan propofol infüzyonubaşlandı. Hastaların kalp atım hızı, sistoloik/diyastolik kan basıncı, oksijen satürasyonu, endtidal karbondioksit değeri ve Ramsey sedasyon skoru 5’er dakikalık aralıklarla kaydedildi. İşlemsüresi, kullanılan propofol miktarı, Aldrete skorlaru 9’a ulaşma zamanı, toplam ve gerekli ekpropofol dozları kaydedildi. Ajitasyon, desatürasyon, bradikardi ve hipotansiyon gibi yan etkilerkaydedildi. Bulgular: Grupların demografik özellikleri arasında anlamlı bir farklılık saptanmadı. Grup 1ile karşılaştırıldığında kalp atım hızı ketamin alan gruplarda 25.,65., 70. ve 75. dakikalarda daha yüksekti (p

Keywords

Propofol, ketamin, MRG sedasyon, çocuklar, ayaktan (günlük vaka)

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