A Prospective Study of Ketamine and Dexmedetomidine for Day Care Anaesthesia in Paediatric Surgery

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A Prospective Study of Ketamine and Dexmedetomidine for Day Care Anaesthesia in Paediatric Surgery

Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 12

Abstract

Introduction: Ketamine is one of the commonly used inducing agent for short surgical procedures particularly in paediatric patients. But, its utility has been restricted because of its unwanted sympathomimetic activity even though it has an excellent analgesic property with minimal respiratory depression. Added to this, it is also associated with undesirable postoperative delirium. In the past, several drugs like Midazolam, Propofol were added to ameliorate the side effects of Ketamine. A Combination of Dexmedetomidine, a short-acting highly selective α2 negates the unwanted sympathomimetic effects of Ketamine. It also reduces the postoperative hallucination and its antiemetic and antisialagogues properties are beneficial. Several studies have been done to evaluate Ketamine and Dexmedetomidine as a sedative in diagnostic and invasive procedures in children. We have studied its efficacy in short surgical procedures in paediatric cases. Materials and Methods: The study was conducted in M.G.M Medical College and Hospital Jamshedpur from January 2017 to December 2017. Day Care surgeries with the average duration of 40 mins were taken under study. All the cases which are maintained by spontaneous mask ventilation were taken for study. The study cases had fasting period of 6 hrs. for solid food and 4 hrs. for clear fluids. All study cases were in the age group between 2 yrs. to 12 yrs. and are ASA GR I. Children with anaemia, CHD and any other associated medical abnormalities were excluded. Results: The Mean PR and BP were found to be stable during the perioperative period. Only one case had bradycardia during intraoperative period, which was corrected with a bolus dose of IV Atropine. Recovery scores showed patient had Aldrete score of 8 after 120 mins. All cases had sedation score of 6 for 2 hrs., which is advantageous to the paediatric age group. All patients had satisfactory analgesia during postoperative period. Conclusion: Ketamine-Dexmedetomidine combination provides good haemodynamic stability during intraoperative period. Dexmedetomidine has addition property of sedation, antiemesis and analgesia, which makes better choice of drug for combining with Ketamine.

Authors and Affiliations

Dr. Sanjeev Kumar

Keywords

EP ID EP428639
DOI 10.9790/0853-1712107577.
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