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Ketamine boluses with continuous low‐dose fentanyl for paediatric sedation during diagnostic cardiac catheterization
Author(s) -
RAUTIAINEN PAULA,
MERETOJA OLLI A.
Publication year - 1993
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.1993.tb00102.x
Subject(s) - medicine , premedication , ketamine , fentanyl , sedation , anesthesia , cardiac catheterization , flunitrazepam , surgery , benzodiazepine , receptor
Summary During cardiac catheterization, 202 children aged 1 month to 16 yrs were sedated intravenously half an hour after oral premedication with flunitrazepam 0.1 mg·kg −1 (maximum dose 2 mg) to maintain spontaneous breathing and stable and calm conditions for the investigation. Standard fentanyl doses for induction and maintenance were 1 μg·kg −1 and 1 μg·kg −1 ·h −1 , respectively, for all patients. Requirements for supplementary ketamine for induction and maintenance of stable sedation were studied in five age groups (≤0.5 yr, >0.5–2 yr, >2.0–5.0 yr, >5.0–10.0 yr and >10.0 yr). Ketamine doses for induction were 1.5 ± 0.1, 1.5 ± 0.1, 1.2 ± 0.1, 0.9 ± 0.1 and 0.2 ± 0.1 (mean ± SEM) mg·kg −1 in these age groups, respectively. Ketamine requirements for maintenance of sedation were 1.9 ± 0.1, 1.7 ± 0.1, 1.4 ± 0.1, 1.1 ± 0.1 and 0.2 ± 0.1 mg·kg −1 ·h −1 in the same age groups, respectively. Age dependency of ketamine requirement was shown; the older the patient the less was the need for supplementation. Intravenous sedation with low‐dose fentanyl and ketamine after flunitrazepam premedication provided favourable anaesthesia for cardiac catheterization.