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Sedation for paediatric transcatheter atrial septal defect closure: comparison of two sedation protocols

Published online by Cambridge University Press:  09 September 2013

Ayşe Ülgey ,
Adnan Bayram ,
Işın Güneş ,
Recep Aksu ,
Cihangir Bicer ,
Aynur Akin ,
Ali Baykan ,
Nazmi Narin  and
Adem Boyaci
Ayşe Ülgey*
Affiliation:
Department of Anaesthesiology, Erciyes University Medical Faculty, Kayseri, Turkey
Adnan Bayram
Affiliation:
Department of Anaesthesiology, Erciyes University Medical Faculty, Kayseri, Turkey
Işın Güneş
Affiliation:
Department of Anaesthesiology, Erciyes University Medical Faculty, Kayseri, Turkey
Recep Aksu
Affiliation:
Department of Anaesthesiology, Erciyes University Medical Faculty, Kayseri, Turkey
Cihangir Bicer
Affiliation:
Department of Anaesthesiology, Erciyes University Medical Faculty, Kayseri, Turkey
Aynur Akin
Affiliation:
Department of Anaesthesiology, Erciyes University Medical Faculty, Kayseri, Turkey
Ali Baykan
Affiliation:
Department of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Nazmi Narin
Affiliation:
Department of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Adem Boyaci
Affiliation:
Department of Anaesthesiology, Erciyes University Medical Faculty, Kayseri, Turkey
*
Correspondence to: Dr A. Ülgey, MD, Assistant professor, M. Şimşek C. Hisar Geçidi. Serdem Apt. No: 8/31 Melikgazi, Kayseri 38030, Turkey. Tel: +00 903 522 076/666/24043/00 905 378 201 751; Fax: +00 903 52 437 7333; E-mail: aulgey@erciyes.edu.tr; aulgey38@gmail.com
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Abstract

Aim: This study aimed to compare the effects of dexmedetomidine–propofol and ketamine–propofol sedation on haemodynamic stability, immobility, and recovery time in children who underwent transcatheter closure of atrial septal defects. Methods: In all, 46 children scheduled for transcatheter closure of atrial septal defects (n = 46) were included. The dexmedetomidine–propofol group (n = 23) received dexmedetomidine (1 μg/kg) and propofol (1 mg/kg) for induction, followed by dexmedetomidine (0.5 μg/kg/hour) and propofol (100 μg/kg/minute) for maintenance. The ketamine–propofol group (n = 23) received ketamine (1 mg/kg) and propofol (1 mg/kg) for induction, followed by ketamine (1 mg/kg) and propofol (100 μg/kg/minute) for maintenance. Results: In all, 11 patients in the dexmedetomidine group (47.8%) and one patient (4.3%) in the ketamine group demonstrated a decrease ≥20% from the baseline in mean arterial pressure (p = 0.01). Heart rates decreased ≥20% from the baseline value in 10 patients (43.4%) in the dexmedetomidine group and three patients (13%) in the ketamine group (p = 0.047). Heart rate values were observed to be lower in the dexmedetomidine group throughout the procedure after the first 10 minutes. The number of patients requiring additional propofol was higher in the dexmedetomidine group (p = 0.01). The recovery times were similar in the two groups – 15.86 ± 6.50 minutes in the dexmedetomidine group and 19.65 ± 8.19 minutes in the ketamine group; p = 0.09. Conclusion: The ketamine–propofol combination was less likely to induce haemodynamic instability, with no significant change in recovery times, compared with the dexmedetomidine–propofol combination. The ketamine–propofol combination provided good conditions for the intervention.

Keywords

Atrial septal defectspropofolketaminedexmedetomidinesedation
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 5 , October 2014 , pp. 880 - 885
Copyright
Copyright © Cambridge University Press 2013 

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