Ketamine infusion versus isoflurane for the maintenance of anesthesia in the prebypass period in children with tetralogy of Fallot.

Abstract

OBJECTIVE:

To evaluate the use of ketamine in comparison with isoflurane in the maintenance of anesthesia in children with tetralogy of Fallot.

DESIGN:

Prospective, randomized study.

SETTING:

University hospital.

PARTICIPANTS:

Fifty children scheduled for correction of tetralogy of Fallot.

INTERVENTIONS:

After intubation, patients were assigned randomly to receive 2 different anesthesia maintenance regimens: group I, isoflurane, 0 to 1% plus fentanyl, 0.1 microg/kg/min; group II, ketamine, 0 to 5 mg/kg/h, plus fentanyl, 0.1 microg/kg/min. Isoflurane concentration and ketamine infusion rate were adjusted to maintain arterial pressure within 25% of baseline. Hemodynamic and respiratory parameters were recorded at the end of 4 intervals: T0, before induction of anesthesia; T1, induction to 10 minutes postintubation; T2, 10 minutes postintubation to poststernotomy; and T3, poststernotomy to completion of catheterizations.

MEASUREMENTS AND MAIN RESULTS:

In comparing group I with group II, significant differences were observed in mean arterial pressure (p < 0.0001), heart rate (p < 0.01), arterial oxygen saturation (p < 0.0001), arterial oxygen tension (p < 0.001), arterial carbon dioxide tension (p < 0.001), arterial pH (p < 0.0001), base excess (p < 0.05), and arterial to end-tidal carbon dioxide tension difference (p < 0.01) at T3.

CONCLUSION:

The use of ketamine anesthesia is recommended as an alternative maintenance regimen in children undergoing definitive correction of tetralogy of Fallot.

• Authors: M Tuğrul, E Camci, K Pembeci, L Telci, K Akpir
• Journal: Journal of cardiothoracic and vascular anesthesia (J Cardiothorac Vasc Anesth) Vol. 14 Issue 5 Pg. 557-61 (Oct 2000) ISSN: 1053-0770 [Print] United States
• PMID: 11052438 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Hemoglobins
• Carbon Dioxide
• Ketamine
• Isoflurane
• Oxygen
• Dopamine
• Epinephrine

Topics

• Anesthesia
• Carbon Dioxide (blood)
• Child
• Child, Preschool
• Dopamine (pharmacology)
• Epinephrine (pharmacology)
• Hemodynamics (drug effects)
• Hemoglobins (analysis)
• Humans
• Infant
• Isoflurane (pharmacology)
• Ketamine (pharmacology)
• Oxygen (blood)
• Prospective Studies
• Tetralogy of Fallot (surgery)