An analytical study of Comparison between Ketamine - Dexmedetomidine versus Ketamine - Propofol for Sedation in Children Undergoing Minor Cardiac Procedures in a Cardiac Catheterization Laboratory

Abstract

Background: The management of children with heart diseases has been a major challenge for cardiac anesthetists. The anesthetic technique to be used should be easy, safer and provide cardiac stability throughout the operation. So cardiac interventionist prefer deep sedation with the patient breathing spontaneously and painlessly in the room. Propofol, Ketamine along with other combinations drugs have been used worldwide by cardiac anesthetists to achieve these goals. We carried out this study to evaluate the combination drugs for pediatric cardiac surgeries which are Ketamine – Dexmedetomidine (KD) and Ketamine – Propofol (KP). Methodology: This study was conducted in the Department of Cardiology. A total number of 80 cases were selected, 40 from each comparative groups of Ketamine – Dexmedetomidine (KD) and Ketamine – Propofol (KP). Patient data was categorized into age, sex, procedure done and recovery time, analgesic boluses required and hemodynamic parameters during the surgery. Results: Mean age in KD group was 5.24 ± 1.25 years and in KP group was 4.95 ± 1.86 years. There were 24 males (60%) and 16 females (40%) in KD group and 22 males (55%) and 18 females (45%) in KP group. Most common procedures done in both the groups was ASD for device closure done in 12 patients (30%) in KD group and 13 patients (32.5%) in KP group. There was significant difference between the mean recovery time and number of ketamine boluses consumption in both the groups. (p<0.05) Heart rate was significantly lower in KD group at 5, 10, 15 and 20 min post induction when compared to KP group. No statistically significance was found in difference between the Mean Respiratory rate and MAP. Conclusion: Our study concludes that the use of KD combination is relatively safe, practical alternative, we did not find any hemodynamic or respiratory effects during the cardiac procedures but there was some delayed recovery.