ORIGINAL ARTICLE
Year : 2012  |  Volume : 6  |  Issue : 2  |  Page : 140-144

Effects of addition of ketamine, fentanyl and saline with Propofol induction on hemodynamics and laryngeal mask airway insertion conditions in oral clonidine premedicated children


1 Department of Critical Care Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
2 Department of Anaesthesia, CSMMU, Lucknow, Uttar Pradesh, India

Correspondence Address:
Tanmoy Ghatak
Rammohan Pally, Arambagh, Hooghly, West Bengal - 712 601
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.97027

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Background: The aim of this double-blind, prospective, randomized, controlled study was to compare the effect of addition of ketamine; fentanyl and saline with propofol anesthesia on hemodynamic profile and laryngeal mask airway (LMA) insertion conditions in oral clonidine premedicated children. Methods: 180 children (age 2 - 10 years) were at first given oral clonidine (4 μg/kg) 90 minutes before operation, and then were randomly allocated to receive either ketamine 0.5 mg/kg (n=60), fentanyl 1 μg/kg (n=60) or 0.9% normal saline (n=60) before induction with propofol 3.0 mg/kg. Insertion of LMA was performed within 1 minute of injection of propofol. Heart rate and mean blood pressure were noted 1 min before induction (baseline), immediately after induction, before and after insertion of LMA for up to 3 min. Following LMA insertion, 6 subjective end points were noted-mouth opening, coughing, swallowing, patient's movement, laryngospasm, and ease of an insertion. LMA insertion summed score was prepared depending upon these variables. Results: LMA insertion summed score was nearly similar in ketamine and fentanyl group, which were significantly better than saline group (P<0.004). Mean blood pressure and heart rate were maintained in ketamine than with fentanyl or saline group. Incidence of prolonged apnea (>120 secs.) was higher in fentanyl group compared to ketamine and saline group. Conclusion: Even in oral clonidine premedicated children, addition of ketamine with propofol provides hemodynamic stability and comparable conditions for LMA insertion like fentanyl propofol with significantly less prolonged apnea.


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