• Medicine · Nov 2022

    Anaesthesia administered as S(+)-ketamine for cardiac intervention in children with common congenital heart disease.

    • Wenjun Liu, Fei Xu, Liyong Guo, Hong Li, Liyun Zhao, and Jun Ma.
    • Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
    • Medicine (Baltimore). 2022 Nov 4; 101 (44): e31624e31624.

    BackgroundSafety and efficacy were assessed of different S(+)-ketamine doses combined with propofol administered as anesthesia to common pediatric congenital heart disease (CHD) patients undergoing cardiac interventional surgery to provide reference data as guidance for use in clinical settings.MethodsSixty CHD children admitted to Beijing Anzhen Hospital, Capital Medical University from December 2020 to December 2021 who underwent elective cardiac intervention were assigned to 3 groups (H, L, M, 20 patients/group) using a random number table-based method. Patients received 1% propofol (2 mg/kg) and intravenous injections of S(+)-ketamine (Group L, 0.4 mg/kg; Group M, 0.5 mg/kg; Group H, 0.6 mg/kg) followed by intravenous pumping of 1% propofol (4-6 mg/kg/h). Heart rate (HR), mean arterial pressure, and pulse oxygen saturation were recorded preoperatively (T0), at the time of anesthesia maintenance (T1), at the time of arteriovenous puncture (T2), and when they awakened (T3). Additionally, propofol dose and incidence rates of intraoperative body movement, postoperative agitation, and postoperative nausea/vomiting were recorded.ResultsFor the 3 groups, Group H awakening time was significantly longer than that of Group L (P = .039). Notably, intergroup intraoperative propofol times differed significantly (P = .009). Meanwhile, T0 to T3 intragroup HR values differences were significant (P = .017; P = .001; P = .005, respectively). Group L HR was significantly elevated at T2 relative to T0 (P = .003), Group M HR was significantly elevated at T1 and T2 relative to T0 (P = .019; P = .003, respectively), and Group H HR values were significantly elevated at T1 and T2 relative to T0 (P = .012; P = .005, respectively). At all 4 time points no statistically significant intergroup differences in mean arterial pressure values were observed (P = .587). T1 to T3 pulse oxygen saturation values for all 3 groups were significantly greater than corresponding T0 values. Although intergroup intraoperative body movement incidence differed significantly (P = .044), intergroup differences in awakening time agitation and postoperative nausea/vomiting incidence rates were insignificant (P = .732, P = .887, respectively).ConclusionUse of 0.6 mg/kg S(+)-ketamine with propofol was most effective as anesthesia for common pediatric CHD patients undergoing cardiac interventional surgery.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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