ISMJ

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Background: The goals for sedation in pediatric patients scheduled to undergo cardiac catheterization include immobility, analgesia, cardiovascular and respiratory stability. We investigated the effects of Propofol and Ketamine on hemodynamic, respiratory status, sedation level, pain score and recovery period in pediatric patients undergoing cardiac catheterization. Methods: We preformed a randomized clinical trial study on 40 pediatric patients. The patients were randomly assigned to two groups, so that 20 patients received Ketamine and 20 patients received Propofol. In all patients, sedation was started with Midazolam (0.03mg/kg), then followed by Propofol in the first group and Ketamine in the second one. The hemodynamic responses, respiratory parameters, recovery characteristics (Ramsey scale, pain score VAS) and relevant adverse effects of the two groups were recorded. Data was analyzed using Paired T Test, ANOVA and Stearman correlation coefficient. Results: Five patients in the Propofol group andon patients in the Ketamine group experienced a transient decrease in mean systolic blood pressure greater than 10% of baseline(p=0.034). Time to full recovery (mean ± SD) was not significantly different in the Propofol group and Ketamine group (1.8 min vs. 2.9 min, P > 0.05). Pain scores were significantly different in both groups (P= 0.010). Patients’ heart rates were significantly higher in Ketamine group(P=0.029). No significant difference in respiratory rate was recorded in both groups(p›0.05). Conclusion: Both Ketamine and Propofol are useful and safe in pediatric patients undergoing cardiac catheterization but it seems that it is better to use Propofol in stable hemodynamic pediatric patients under continuous blood pressure monitoring.

Keywords: propofol, ketamine, sedation, pediatric patients, heart catheterization

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