Comparison of propofol with propofol-ketamine combination in pediatric patients undergoing auditory brainstem response testing

Aynur Akin, Aliye Esmaoglu, Zeynep Tosun, Nebahat Gulcu, Harun Aydogan, Adem Boyaci
International Journal of Pediatric Otorhinolaryngology 2005, 69 (11): 1541-5

OBJECTIVE: The aim of our study was to compare propofol with propofol-ketamine combination for sedation and also to compare related complications in children undergoing auditory brainstem response (ABR) testing.

METHODS: Sixty ASA I-II patients aged between 1 and 13 years of age were sedated for ABR testing. Propofol 1.5mg/kg was used in group P (n=30), and ketamine 0.5 mg/kg+propofol 1.5 mg/kg, i.v., in group PK (n=30). Sedation levels of patients were maintained between scores 3 and 4 according to Ramsey sedation scores; when necessary, half of the starting drug dosage was administered for the maintenance of sedation. Side effects which occurred during or within the first 24h of the procedure were assessed.

RESULTS: Additional dosage was needed for 21 cases in group P and eight cases in group PK (p=0.002). While oxygen desaturation and apnea were not observed in any of the patients in group PK, there were four patients (11.4%) with oxygen desaturation, and six (17.1%) with apnea in group P (p<0.05).

CONCLUSIONS: In pediatric cases where ABR testing was applied, addition of low dose ketamine to propofol avoided the risk of respiratory depression due to propofol and lowered the need for additional dose of propofol. Therefore, the co-administration of propofol and ketamine appears to be a safe and useful technique for ABR testing.

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