We have located links that may give you full text access.
Dexmedetomidine and ketamine for sedation during spinal anesthesia in children.
Journal of Clinical Anesthesia 2010 November
STUDY OBJECTIVE: To evaluate the combination of dexmedetomidine and ketamine for sedation during lumbar puncture and sedation for spinal anesthesia in children.
DESIGN: Retrospective analysis of quality assurance data sheets and anesthetic records.
SETTING: Developing countries with the humanitarian group, Kids First.
PATIENTS: 12 infants and children, ranging in age from two to 9 years.
INTERVENTIONS: A bolus dose of ketamine (two mg/kg) and dexmedetomidine (one μg/kg) was given over three minutes followed by a continuous infusion of dexmedetomidine (two μg/kg/hr for the first 30 min, followed by one μg/kg/hr for the duration of the case). Supplemental analgesia/sedation was provided by ketamine (0.5 mg/kg) as needed.
MEASUREMENTS: The need for supplemental ketamine, the ability to complete the procedure, and heart rate (HR), blood pressure, end-tidal carbon dioxide (ETCO(2)), and oxygen saturation values were recorded.
MAIN RESULTS: Effective sedation for lumbar puncture and performance of spinal anesthesia were achieved in all patients. One patient required a supplemental dose of ketamine (0.5 mg/kg). Following the bolus dose of ketamine and dexmedetomidine, HR increased by 11 ± 4 bpm. The greatest HR increase was 20 bpm. No patient had a HR increase ≥ 20% from baseline. The HR decrease was ≤ 30 bpm in 10 of the 12 patients, and the greatest HR decrease was 58 bpm. Systolic blood pressure (SBP) increased from baseline by 10 ± 3 mmHg after administration of the bolus dose of ketamine and dexmedetomidine. During the subsequent dexmedetomidine infusion, SBP decreased by 11 ± 9 mmHg. No patient's respiratory rate decreased to less than 10 breaths/min or increased above 24 breaths/min during the procedural sedation. The highest ETCO(2) was 45 ± 2 mmHg (P < 0.0001). Oxygen saturation remained ≥ 95% during the procedure in all patients.
CONCLUSION: A combination of ketamine and dexmedetomidine provides effective sedation during spinal anesthesia in infants and children, with limited effects on cardiovascular and ventilatory function.
DESIGN: Retrospective analysis of quality assurance data sheets and anesthetic records.
SETTING: Developing countries with the humanitarian group, Kids First.
PATIENTS: 12 infants and children, ranging in age from two to 9 years.
INTERVENTIONS: A bolus dose of ketamine (two mg/kg) and dexmedetomidine (one μg/kg) was given over three minutes followed by a continuous infusion of dexmedetomidine (two μg/kg/hr for the first 30 min, followed by one μg/kg/hr for the duration of the case). Supplemental analgesia/sedation was provided by ketamine (0.5 mg/kg) as needed.
MEASUREMENTS: The need for supplemental ketamine, the ability to complete the procedure, and heart rate (HR), blood pressure, end-tidal carbon dioxide (ETCO(2)), and oxygen saturation values were recorded.
MAIN RESULTS: Effective sedation for lumbar puncture and performance of spinal anesthesia were achieved in all patients. One patient required a supplemental dose of ketamine (0.5 mg/kg). Following the bolus dose of ketamine and dexmedetomidine, HR increased by 11 ± 4 bpm. The greatest HR increase was 20 bpm. No patient had a HR increase ≥ 20% from baseline. The HR decrease was ≤ 30 bpm in 10 of the 12 patients, and the greatest HR decrease was 58 bpm. Systolic blood pressure (SBP) increased from baseline by 10 ± 3 mmHg after administration of the bolus dose of ketamine and dexmedetomidine. During the subsequent dexmedetomidine infusion, SBP decreased by 11 ± 9 mmHg. No patient's respiratory rate decreased to less than 10 breaths/min or increased above 24 breaths/min during the procedural sedation. The highest ETCO(2) was 45 ± 2 mmHg (P < 0.0001). Oxygen saturation remained ≥ 95% during the procedure in all patients.
CONCLUSION: A combination of ketamine and dexmedetomidine provides effective sedation during spinal anesthesia in infants and children, with limited effects on cardiovascular and ventilatory function.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app