Omprakash, S (2009) Efficacy of Ketamine Co-Induction with Propofol for LMA Insertion in Children. Masters thesis, Madras Medical College, Chennai.
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Abstract
BACKGROUND: Large doses of propofol needed for induction and laryngeal mask (LMA) insertion in children may be associated with hemodynamic and respiratory effects .Co-induction has the advantage of reducing dose and therefore maintaining hemodynamic stability. OBJECTIVES: Use of ketamine lowers the induction dose of propofol (co- induction) producing hemodynamic stability. METHODS/MATERIALS: A prospective, randomized, double-blind, controlled study was conducted in 40 ASA I/II children, age 1-8years. Normal saline, Ketamine 0.5 mg/kg were administered in P (propofol) and PK (propofol-ketamine) group respectively, 2 min prior to administration of the induction dose of propofol. Propofol 2.5 mg/kg given as induction in groups (P and PK), LMA inserted 30s later and insertion conditions assessed. Heart rate and Blood pressure were recorded immediately after propofol bolus, then every min till 2 min after LMA insertion. Recovery was assessed using Steward’s score. RESULTS: 20% of the patient in PK group had MAP fall > 20% compared to 45 % in P group. This difference was not statistically significant and thus ketamine propofol coinduction for LMA insertion produce no better hemodynamic stability compared to propofol alone. ketamine co induction with propofol produced comparably better condition for LMA insertion( 3/ 20) than propofol alone (0/20 ) and significantly reduced the total induction dose of propofol {39 +/- 9.2, ( 3.1 mg/kg)} compared to propofol alone {55.2 +/- 10.4 ,(4.7 mg/kg )} for LMA insertion [p <0.005]. , but this is at the expense of recovery time with PK group (58.7+/- 25) taking significantly longer recovery time compared to P group (44.5 min +/-14.7) {p < 0.05}. CONCLUSION : The result of this study showed that the co-induction with ketamine prior to propofol induction for LMA insertion in children decreases the total dose of propofol used for induction, however this advantage is at the expense of prolonging the recovery time. Ketamine co-induction with propofol showed no better significant hemodynamic stability compared to propofol group.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Efficacy ; Ketamine Co-Induction ; Propofol ; LMA Insertion ; Children. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Subramani R |
| Date Deposited: | 21 Apr 2018 13:26 |
| Last Modified: | 21 Apr 2018 13:26 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7193 |
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