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Ketamine + Propofol Speeds Recovery for Peds MRI Sedation

WEDNESDAY, Feb. 7, 2018 -- Use of ketamine at induction followed by reduced propofol infusion rate for maintenance is associated with shorter recovery times for children undergoing magnetic resonance imaging with deep sedation, according to a study published online Jan. 27 in Pediatric Anesthesia.

Achim Schmitz, M.D., from the University Children's Hospital in Zurich, and colleagues randomly assigned 347 children aged 3 months to 10 years scheduled as outpatients for elective magnetic resonance imaging with deep sedation to receive either 1 mg/kg ketamine at induction followed by a propofol infusion rate of 5 mg/kg/hour or a propofol infusion rate of 10 mg/kg/hour without ketamine. The primary outcome was time to full recovery.

The researchers found that the ketamine-propofol group experienced significantly shorter recovery times (38 versus 54 minutes; median difference, 14 minutes; P < 0.001), as well as better quality of induction and higher blood pressure. But, the incidence of movement requiring additional sedative drugs was higher in the ketamine-propofol group. Respiratory side effects, cardiovascular compromise, emergence delirium, and postoperative nausea and vomiting did not differ significantly between the groups.

"Both sedation concepts proved to be reliable with a low incidence of side effects," the authors write. "Ketamine at induction with a reduced propofol infusion rate leads to faster postanesthetic recovery."

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Posted: February 2018