|
|
Effects of dexmedetomidine and propofol used alone or combined with ketamine in local chemotherapy through ophthalmic artery of retinoblastoma in pediatric patients |
LI Zhanjun, LIU Duohui, AN Lina, DONG Lan , TAN Dianxue, and YANG Shufeng |
Department of Anesthesiology, General Hospital of Chinese People’s Armed Police Force, Beijing 100039,China |
|
|
Abstract Objective To evaluate the clinical value of dexmedetomidine and propofol used separately or in combination with ketamine in local chemotherapy through ophthalmic artery of retinoblastoma in pediatric patients. Methods 60 children with retinoblastoma were randomly divided into three groups: group D, group P and group DP. Subjects in each group were given atropine 0.02 mg/kg and ketamine 2.0 mg/kg as induced anesthesia. The dose of each anesthetic was maintainted at the same time. Femoral artery puncture began soon after the children fell asleep. BIS, BP, HR, RR and SpO2 of these patients were recorded at different time points. The total amount of ketamine, cases who needed additional ketamine and atropine,the operation time and awakening time were recorded as well. Also, the incidence of adverse events such as respiratory depression and postoperative agitation was observed. Results Compared to T0, BIS decreased from T2 to T4 in these groups, while NBP was reduced from T3 to T4 in group P. There was no significant difference of HR, RR and SpO2 between these three groups at each time point. Compared to group D, the total amount and additional injection of ketamine was significantly reduced in group P and DP (P<0.05 or P<0.01). There were far more respiratory depression events in group P than in the other two groups. There was no significant difference in postoperative recovery status between these groups. Conclusions During local chemotherapy through ophthalmic artery in pediatric patients of RB, ketamine, when combined with dexmedetomidine andmaintained at the dose of 0.5 μg/(kg·h) or with propofol maintained at the dose of 5 mg/(kg·h), can produce effective sedation and analgesia with few adverse reactions. This should be a suitable combination of anesthesia in operations of this kind.
|
Received: 16 January 2016
|
|
|
|
|
[1] |
Hosokawa K, Shime N, Kato Y, et al. Dexmedetomidine sedation in children after cardiac surgeru[J]. Pediatr Crit Care Med, 2010,11(1):39-43.
|
[2] |
Phan H,Nahata M C.Clinical uses of dexmedetomidine in pediatric patients[J].Pediatr Drugs,2008,10(1):49-69.
|
[3] |
Vereecke H E, Struys M M, Mortier E P. A comparison of bis-pectral index and ARX-derived auditory evoked potential index in measuring the clinical interaction between ketamine and propofol anaesthesia[J]. Anaesthesia,2003,58(10):957-961.
|
[4] |
Mc Vey J D, Tobias J D. Dexmedetomidine and ketamine for sedation during spinal anesthesia in children[J].J Clin Anesth, 2010,22(7):538-545.
|
[5] |
李占军,韩曙君,董 兰,等.不同剂量右美托咪定复合氯胺酮用于患儿室间隔缺损封堵术的麻醉效果[J].中华麻醉学杂志,2014,34(4):402-404.
|
|
|
|