• Alexander Kogan, Rachel Efrat, Jacob Katz, and Bernardo A Vidne.
• Department of Cardiothoracic Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel. akogan@clalit.org.il
• J. Cardiothorac. Vasc. Anesth. 2003 Dec 1; 17 (6): 691-3.

ObjectiveTo evaluate the safety of a propofol-ketamine mixture to induce and maintain anesthesia in spontaneously breathing pediatric patents during cardiac catheterization.DesignProspective clinical study.SettingDepartments of Cardiothoracic Surgery, Anesthesiology, and Pediatric Anesthesiology in a university hospital.ParticipantsForty-five children aged 6 months to 16 years with ASA grade II to III undergoing cardiac catheterization.InterventionsContinuous intravenous infusion of a mixture of propofol (4 mg/mL) and ketamine (2 mg/mL) with spontaneous ventilation. The infusion rate was changed and additional boluses of propofol or/and ketamine were given as needed. Hemodynamic, respiratory, and other variables were recorded during the procedure and recovery.ResultsMean dose of ketamine was 26 +/- 8.3 microg/kg/min and of propofol, 68.3 +/- 21.7 microg/kg/min. Changes in heart rate and mean arterial pressure of more than 20% from baseline were observed in 4 and 5 patients, respectively. A transient reduction in oxygen saturation because of hypoventilation was observed in 3 patients and responded to oxygen administration and manual assisted ventilation. No other complications were observed.ConclusionsThe propofol-ketamine mixture is a safe, practical alternative for general anesthesia in pediatric patients undergoing cardiac catheterization.

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