Effects of low dose ketamine before induction on propofol anesthesia for pediatric magnetic resonance imaging

Tomatir, Erkan; Atalay, Habip; Gürses, Ercan; Erbay, Hakan; Bozkurt, Pervin

doi:10.1111/j.1460-9592.2004.01303.x

Cited by 64 publications

(66 citation statements)

References 20 publications

(24 reference statements)

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“…Several investigators, in various studies which were done, found that the co administration of ketamine with propofol during induction prevented the adverse haemodynamic outcomes which were seen when propofol was used alone [5,6]. Several strategies, including IV administration of 0.5 mg/kg ketamine prior to propofol induction and infusion, have been shown to decrease adverse haemodynamic events which were associated with isolated use of propofol [5].…”

Section: Resultsmentioning

confidence: 99%

Comparison of Propofol and Ketamine versus Propofol and Fentanyl for Puerperal Sterilization, A Randomized Clinical Tria

Cherian

Balachander

et al. 2014

JCDR

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Background: Puerperal sterilization requires a rapid recovery of the mother so that she can take care of her child. Propofol with fentanyl (PF) is an option, but is associated with intraoperative hypotension, respiratory depression and an unsatisfactory postoperative recovery profile. Propofol with ketamine (PK) appears to be an alternative in terms of haemodynamic stability and analgesia. Materials and Methods:This randomized clinical trial involved 60 patients who were scheduled to undergo puerperal sterilization, who belonged to American society of anaesthesiologists (ASA) physical status 1. Patients were randomly allocated to receive either ketamine -propofol infusion in a concentration of 8mg/ml each (group PK) or fentanyl 2µg/kg intravenously, followed by an infusion of propofol in a concentration of 8mg/ml (group PF). In both the groups, the infusion was started at 300ml/hr till patient lost consciousness. Subsequently, the rate was set at 1.5ml/ kg/hr for group PF and at 0.75ml/kg/hr for group PK. After the initial 10 minutes, the infusion rate was reduced to 1ml/kg/hr for group PF and to 0.5ml/kg/hr for group PK. Blood pressure and saturation were the primary outcomes which were measured.

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Section: Resultsmentioning

confidence: 99%

Comparison of Propofol and Ketamine versus Propofol and Fentanyl for Puerperal Sterilization, A Randomized Clinical Tria

Cherian

Balachander

et al. 2014

JCDR

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“…administration of katamine. 14,15 In this study group A having highest fraction of ketamine in ketofol so the blood level of ketamine rises rapidly. LMA insertion time was significantly (p-0.0089) less in groups C and D comparing group A and B. Ketamine produces increase in muscle tone some time spasm.…”

Section: Discussionmentioning

confidence: 81%

Assessment of effect of various concentration of ketamine-propofol (ketofol) on haemodynamic parameters and LMA insertion conditions

2018

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Background: The purpose of this study is to compare the effect of various concentration of ketamine-propofol (ketofol) on LMA insertion condition and hemodynamic parameters.Methods: Hundred patients of ASA I, II, aged between 18-65 years, were randomized in group A, B, C and D, each consist of 26, 25, 25, 24 patients respectively. They were premedicated with injection GPL, injection midazolam, injection fentanyl and induced with ketofol in 1:1, 1:2, 1:3 and 1:4 ratio in Group A, B, C, D respectively. 60 seconds after induction LMA insertion condition including mouth opening, swallowing, coughing, head and body movements, laryngospasm, ease of LMA insertion, apnea time, and time of LMA insertion were recorded. They were scored 1 to 3. Hemodynamic parameters- heart rate, noninvasive blood pressure and SPO2 were recorded before induction (T1), immediately following induction (T2), immediately after LMA insertion (T3), 5mins after LMA insertion (T4) and 10 mins after LMA insertion (T5).Results: Total 100 patients were included in this prospective randomized double-blind study between April 2017 to March 2018. Pulse rate at (T3) was significantly lower (P-0.06) in group C and D. Diastolic BP was found lower at (T2) time (P-0.04) in group C and D. Apnea time was longest in group A (P-0.002) LMA insertion time was minimum in group B (P-0.008).Conclusions: Addition of low dose of ketamine in propofol favour LMA insertion, due to opposite effect on muscle tone, better relaxation but heart rate, blood pressure remains stable with 1:1, 1:2 ratio of ketofol.

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“…10 Tomatir et al reported that, use of small dose of Ketamine 0.5 mg/kg allows successful scan completion with lower induction and maintenance doses of propofol beside haemodynamic stability. 11 Eirch et al in their observational study found single dose of ketamine 0.5 mg/kg reduced propofol requirement for paediatric MRI compared to propofol and propofol ketamine group with faster recovery after scan completion. 12 Study has shown combination of Propofol and Ketamine is a better sedation with less side effects than using either drug alone.…”

Section: Discussionmentioning

confidence: 97%

Comparison of propofol and thiopentone along with ketamine for paediatric MRI sedation

et al. 2016

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INTRODUCTIONMagnetic resonance imaging (MRI) requires the patient to stay still for at least 15 minutes to one hour in a noisy and claustrophobic environment. It is difficult especially in infants and children without drug induced sleep. Hence anaesthesiologists are discovering safe and successful combination of drugs. 1Propofol is discussed to be a best of all intravenous (I.V.) drugs for paediatric sedation because of its faster induction and quick recovery.2 Magnetic resonance imaging scanning for children is a big challenge for anaesthesiologist for providing adequate sedation without compromising airway and haemodynamics. 3 The success of sedation during MRI is typically assessed by two factors 1) safety during sedation 2) successful completion of test that is good quality of radiological image without artefacts. It can be achieved from motion less body during scan. 4 Propofol yields faster induction and faster emergence from sedation but it may cause hypotension. 5Thiopentone I.V bolus has been used routinely 6 but the duration of recovery and sedation is unpredictable. 7 We aimed to study the effectiveness between Propofol and Thiopentone along with Ketamine and other premedications. ABSTRACTBackground: Children are very much scared to undergo magnetic resonance imaging (MRI) brain or any body part even along with their parents for about 15 to 25 minutes. We investigated the combination of Propofol Ketamine and Thiopentone Ketamine along with Glycopyrolate and Midazolam premedication to see safe and better sedation group for paediatric MRI. Methods: We investigated randomly 50 children of age three to five years prospectively. Children were premedicated with Glycopyrolate 0.01 mg/kg and Midazolam 0.05 mg/kg per body weight intravenously. Ketamine 1 mg/kg body weight was given just before shifting into the MRI machine. After body positioning either Propofol (PK group) or Thiopentone (TK group) 1 mg/kg body weight was given slowly. Children were monitored for electrocardiogram (ECG), arterial oxygen saturation (SpO 2 ) and respiratory rate continuously. Oxygen supplementation was through the oxygen (O 2 ) mask. Three parameters were studied 1) Repetition of drug 2) Respiratory distress during scan period and 3) Recovery time. Results: The pre-interventional characteristics including age, sex, weight, ASA grade, were comparable between two groups (p>0.050). Repetition in PK group was high compared to TK group (40% vs 8%; p=0.0081). Respiratory distress was comparable in both the groups (16% vs 24%; p=0.480) whereas recovery time was significantly shorter for PK group (4.62 ± 0.53 vs 9.86 vs 1.28; p<0.001). Conclusions: Thiopentone Ketamine combination results in lower repetition rate while Propofol Ketamine offers shorter recovery period. However, respiratory distress is almost similar.

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Effects of low dose ketamine before induction on propofol anesthesia for pediatric magnetic resonance imaging

Abstract: Intravenous administration of low dose ketamine before induction and maintenance with propofol preserves hemodynamic stability without changing the duration and the quality of recovery compared with propofol alone.

Cited by 64 publications

References 20 publications

Comparison of Propofol and Ketamine versus Propofol and Fentanyl for Puerperal Sterilization, A Randomized Clinical Tria

Comparison of Propofol and Ketamine versus Propofol and Fentanyl for Puerperal Sterilization, A Randomized Clinical Tria

Assessment of effect of various concentration of ketamine-propofol (ketofol) on haemodynamic parameters and LMA insertion conditions

Comparison of propofol and thiopentone along with ketamine for paediatric MRI sedation

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