Pediatric cardiac catheterization procedure with dexmedetomidine sedation: Radiographic airway patency assessment

Thimmarayappa, Ashwini; Chandrasekaran, Nivash; Jagadeesh, AM; Joshi, Shreedhar

doi:10.4103/0971-9784.148318

Cited by 5 publications

(1 citation statement)

References 23 publications

(21 reference statements)

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“…[ 15 ] In a study conducted by Thimmarayappa et al ., airway patency was measured objectively during dexmedetomidine sedation under radiographic guidance in spontaneously breathing pediatric patients scheduled for cardiac catheterization procedures. [ 16 ] The average recovery time from dexmedetomidine sedation after stopping the infusion was 39.86 ± 12.22 min with maximum being 70 min.…”

Section: Discussionmentioning

confidence: 99%

Comparison of dexmedetomidine and ketamine versus propofol and ketamine for procedural sedation in children undergoing minor cardiac procedures in cardiac catheterization laboratory

Joshi¹,

Kollu

Sharma

2017

Ann Card Anaesth

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Background:The ideal anaesthetic technique for management of paediatric patients scheduled to undergo cardiac catheterisation is still not standardised.Aim:To compare the effects of ketamine-propofol and ketamine-dexmedetomidine combinations on hemodynamic parameters and recovery time in paediatric patients undergoing minor procedures and cardiac catheterisation under sedation for various congenital heart diseases.Material and Methods:60 children of either sex undergoing cardiac catheterisation were randomly assigned into two groups Dexmedetomidine-ketamine group (DK) and Propofol-ketamine (PK) of 30 patients each. All patients were premedicated with glycopyrrolate and midazolam (0.05mg/kg) intravenously 5-10 min before anaesthetic induction. Group ‘DK’received dexmedetomidineiv infusion 1 μg/kg over 10 min + ketamine1mg/kg bolus, followed by iv infusion of dexmedetomidine 0.5μg/kg/hr and of ketamine1 mg/kg/hr. Group ‘PK’ received propofol 1mg/kg and ketamine 1mg/kg/hr for induction followed by iv infusion of propofol 100 μg/kg/hr and ketamine 1 mg/kg/hr for maintenance. Haemodynamic parameters and recovery time was recorded postoperatively.Statistical Analysis:Independent sample t test was used to compare the statistical significance of continuous variables of both the groups. Chi square test was used for numerical data like gender. Fischer exact test was applied for non parametric data like ketamine consumption.Results:We observed that heart rate in dexmedetomidine (DK) group was significantly lower during the initial 25 mins after induction compared to the propofol (PK) group. Recovery was prolonged in the DK group compared to the PK group (40.88 vs. 22.28 min). Even ketamine boluses consumption was higher in DK group.Conclusion:Use of dexmedetomidine-ketamine combination is a safe alternative, without any hemodynamic orrespiratory effects during the cardiac catheterization procedure but with some delayed recovery.

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Section: Discussionmentioning

confidence: 99%

Comparison of dexmedetomidine and ketamine versus propofol and ketamine for procedural sedation in children undergoing minor cardiac procedures in cardiac catheterization laboratory

Joshi¹,

Kollu

Sharma

2017

Ann Card Anaesth

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Does dexmedetomidine cause less airway collapse than propofol when used for deep sedation?

Watt

Sabouri

Hegazy

et al. 2016

Journal of Clinical Anesthesia

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European Society of Anaesthesiology and European Board of Anaesthesiology guidelines for procedural sedation and analgesia in adults

Hinkelbein

Lamperti

Åkeson

et al. 2018

European Journal of Anaesthesiology

217

211

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: Procedural sedation and analgesia (PSA) has become a widespread practice given the increasing demand to relieve anxiety, discomfort and pain during invasive diagnostic and therapeutic procedures. The role of, and credentialing required by, anaesthesiologists and practitioners performing PSA has been debated for years in different guidelines. For this reason, the European Society of Anaesthesiology (ESA) and the European Board of Anaesthesiology have created a taskforce of experts that has been assigned to create an evidence-based guideline and, whenever the evidence was weak, a consensus amongst experts on: the evaluation of adult patients undergoing PSA, the role and competences required for the clinicians to safely perform PSA, the commonly used drugs for PSA, the adverse events that PSA can lead to, the minimum monitoring requirements and post-procedure discharge criteria. A search of the literature from 2003 to 2016 was performed by a professional librarian and the retrieved articles were analysed to allow a critical appraisal according to the Grading of Recommendations Assessment, Development and Evaluation method. The Taskforce selected 2248 articles. Where there was insufficiently clear and concordant evidence on a topic, the Rand Appropriateness Method with three rounds of Delphi voting was used to obtain the highest level of consensus among the taskforce experts.These guidelines contain recommendations on PSA in the adult population. It does not address sedation performed in the ICU or in children and it does not aim to provide a legal statement on how PSA should be performed and by whom. The National Societies of Anaesthesiology and Ministries of Health should use this evidence-based document to help decision-making on how PSA should be performed in their countries. The final draft of the document was available to ESA members via the website for 4 weeks with the facility for them to upload their comments. Comments and suggestions of individual members and national Societies were considered and the guidelines were amended accordingly. The ESA guidelines Committee and ESA board finally approved and ratified it before publication.

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Pediatric cardiac catheterization procedure with dexmedetomidine sedation: Radiographic airway patency assessment

Cited by 5 publications

References 23 publications

Comparison of dexmedetomidine and ketamine versus propofol and ketamine for procedural sedation in children undergoing minor cardiac procedures in cardiac catheterization laboratory

Comparison of dexmedetomidine and ketamine versus propofol and ketamine for procedural sedation in children undergoing minor cardiac procedures in cardiac catheterization laboratory

Does dexmedetomidine cause less airway collapse than propofol when used for deep sedation?

European Society of Anaesthesiology and European Board of Anaesthesiology guidelines for procedural sedation and analgesia in adults

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