Sedative efficacy of S-ketamine combined with propofol for MRI examination in pediatric patients / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the sedative efficacy of S-ketamine combined with propofol for MRI examination in pediatric patients.Methods:One hundred children of both sexes, aged 1-6 yr, weighing 10-30 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, who underwent MRI from February to June 2021, were selected and divided into 2 groups ( n=50 each) by a random number table method: propofol group (P group) and S-ketamine plus propofol group (K+ P group). Anesthesia induction: propofol 2.5 mg/kg was intravenously injected in group P, and S-ketamine 0.5 mg/kg and propofol 1.5 mg/kg were intravenously injected in group K+ P.Anesthesia maintenance: propofol 100 μg·kg -1·min -1 was intravenously infused, and the infusion rate of propofol was adjusted to maintain Ramsay sedation score ≥5.Propofol 0.5-1.0 mg/kg was intravenously injected and/or increasing the infusion rate of propofol when moderate and severe movement occurred.The quality of MRI images was evaluated during the examination, and the occurrence and degree of movement, airway-related adverse events (hypoxemia, apnea, upper airway obstruction, hypersalivation), hypotension and bradycardia were recorded.The average infusion rate, consumption of additional propofol for intravenous administration and total consumption of propofol were recorded.The emergence time and time of anesthesia recovery room stay were recorded.The occurrence of adverse events (vomiting, diplopia and agitation) and the parents′ satisfaction with sedative efficacy and recovery were recorded during observation in the recovery room. Results:Compared with group P, the average infusion rate of propofol, total consumption of propofol, airway-related adverse events and incidence of hypotension and bradycardia were significantly decreased ( P<0.05), and no significant change was found in the incidence and degree of body movement, quality of MRI images, emergence time and time of anesthesia recovery room stay and incidence of adverse events during recovery from anesthesia in group K+ P ( P>0.05). Conclusion:S-ketamine combined with propofol can be safely and effectively used in MRI examination in pediatric patients.