Ketamine–propofol versus ketamine fentanyl for anesthesia in pediatric patients undergoing cardiac catheterization: A prospective randomized study

Objective
The aim of the study was to assess, compare the safety and efficacy of continuous IV administration of a combination of ketamine–propofol versus ketamine fentanyl for anesthesia in children undergoing cardiac catheterization procedures with RT to Lt Shunt.
Methods
Thirty-six children aged from 1 to 8 years, with RT to Lt Shunt scheduled for Cardiac catheterization in Mansoura Children Hospital were included in this study. Patients in group KP ( = 18) received ketamine (1 mg/kg) and propofol (2 mg/kg) as induction agents followed by combination of ketamine (25 μg/kg/min) and propofol (25 μg/kg/min) for maintenance of anesthesia. On other hand, patients in group KF ( = 18) received ketamine (1 mg/kg) and fentanyl (1 μg/kg) as induction agents followed by combination of ketamine (25 μg/kg/min) and fentanyl (0.75 μg/kg/min) for maintenance of anesthesia. Hemodynamic, oxygenation, recovery variables and side effects were recorded.
Results
There were no statistical significant differences with age, sex, duration of anesthesia. There were statistical significant decreases in mean arterial blood pressure (MAP), systemic vascular resistance (SVR), pulmonary to systemic vascular resistance ratio in KP group. Additionally, Sao and Pao after anesthesia in KF group were statistically significant higher than the other group. Also there was significant prolongation of time to full recovery in KF group compared with KP group.
Conclusion
We concluded that a combination of ketamine–fentanyl is safer and more efficacious than ketamine–propofol for pediatric cardiac catheterization although it was associated with prolonged recovery time.