Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2008
Randomized Controlled Trial Comparative StudyPropofol-ketamine vs propofol-fentanyl combinations for deep sedation and analgesia in pediatric patients undergoing burn dressing changes.
The aim of this study was to compare propofol-ketamine (PK) and propofol-fentanyl (PF) combinations for deep sedation and analgesia in pediatric burn wound dressing changes. ⋯ Both propofol-ketamine and propofol-fentanyl combinations provided effective sedation and analgesia during dressing changes in pediatric burn patients. But propofol-ketamine combination was superior to propofol-fentanyl combination because of more restlessness in patients given propofol-fentanyl.
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The aim of this study was to describe ketamine pharmacodynamics (PD) in children. Adult ketamine concentrations during recovery are reported as 0.74 mg.l(-1) (sd 0.24 mg.l(-1)) with an EC(50) for anesthesia of 2 mg.l(-1) (sd 0.5 mg.l(-1)), but pediatric data are few. ⋯ Concentrations associated with arousal in children are analogous to adults. The ability to recall and remember occurs at similar concentrations to those associated with arousal. A concentration of 1 mg.l(-1) was associated with a sedation level of three or less (arouses to consciousness with moderate tactile or loud verbal stimulus) in 95% of children while 1.5 mg.l(-1) was associated with a sedation level of two or less (rouses slowly to consciousness with sustained painful stimulus) in 95% of children. These concentrations can be attained for 3-4 min after 1 mg.kg(-1) and 1.5 mg.kg(-1) ketamine IV bolus, respectively. The mean arousal time can be anticipated at approximately 10 min (1 mg.kg(-1)) and 15 min (1.5 mg.kg(-1)).
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Paediatric anaesthesia · Jan 2008
Letter Randomized Controlled Trial Comparative StudySevoflurane vs ketamine-midazolam for the anesthetic management of children undergoing extracorporeal shock wave lithotripsy.