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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 6, November-December 2019, Pages 2133-2137
 

Original Article

Ketamine 0.5 mg.kg-1 as Co-induction Agent with Propofol 2.5 mg.kg-1 Vs Propofol 3.5 mg.kg-1 for Laryngeal Mask Airway Insertion in Children: A Clinical Comparative Study

Kumara AB1, Ashwini S2, Gurudatta KN3

1,2Assistant Professor, 3Professor and Head, Department of Anesthesiology, Shivamogga Institute of Medical Sciences, Shivamogga, Karnataka 577201, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6619.40

Abstract

Introduction: Propofol is the widely used induction agent for smooth insertion of laryngeal mask in children who require a larger dose compared to adults1–3 and hemodynamic and respiratory effects like hypotension,2,4 bradycardia, apnoea, hypoventilation4 may be exaggerated. The present study was undertaken with the objectives to assess (i) effectiveness of ketamine as a co-induction agent in lowering the induction dose of propofol while producing favorable insertion characteristics for Laryngeal Mask Airway insertion in children (ii) safety in producing hemodynamic stability (iii) recovery of the patient. Methods: ASA I and II, aged 3–10 years children posted for elective short surgical procedures were allocated randomly into two groups of 30 each. Patients in Group P received propofol 3.5 mg.kg-1 and Group KP received intravenous ketamine 0.5 mg. kg-1 two minutes prior to propofol 2.5 mg.kg-1. LMA insertion characteristics assessed in the next 30s using (1) “mouth opening” graded on a three-point scale-full, partial and impossible (2) “the ease of LMA insertion” graded on a four-point scale-easy, some difficulty, difficult and impossible. The hemodynamic parameters recorded immediately after ketamine, propofol (0 min), thereafter at 1 minute interval for 5 minutes. At the end of surgery, LMA removed once the child was adequately recovered. Statistical evaluation done using Frequencies and Crosstabs, Paired Sample t - test and Repeated measure ANOVA. Results: Ketamine as a co-induction agent with propofol produced favorable conditions for smooth insertion of laryngeal mask in children while providing greater hemodynamic stability.


Keywords : Co-induction; Ketamine; Propofol; Laryngeal mask airway.
Corresponding Author : Ashwini S