The effect of alfentanil versus ketamine on the intubation condition and hemodynamics with low-dose rocuronium in children |
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Authors: | Ji Young Kim Jong Seok Lee Hee Yeon Park Yong Beom Kim Youngjun Kwon Hyun Jeong Kwak |
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Institution: | 1. Department of Anesthesiology and Pain Medicine, Anesthesiology and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea 2. Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, South Korea
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Abstract: | Purpose We investigated the effect of alfentanil and ketamine on the intubation condition and hemodynamic parameters during propofol anesthesia with low-dose rocuronium in children. Methods Fifty-four children, aged 3–9 years undergoing tonsillectomy, were randomly allocated to receive either alfentanil 20 μg/kg (alfentanil group, n = 27) or ketamine 0.5 mg/kg (ketamine group, n = 27) 1 min before anesthesia induction. Anesthesia was induced with propofol 2.5 mg/kg and rocuronium 0.3 mg/kg and maintained with propofol infusion (6 mg/kg/h). The neuromuscular relaxation was monitored, and intubation conditions, hemodynamic changes, and recovery time were assessed. Results All patients were successfully intubated and there were no significant differences in the intubation conditions between alfentanil and ketamine groups. At the time of tracheal intubation, the median inter-quartile range] twitch height was similar between two groups (37 4–48] % in the alfentanil group vs. 29 4–43.5] % in the ketamine group, p = 0.326). Conclusions This study showed that both ketamine 0.5 mg/kg and alfentanil 20 μg/kg provided adequate intubation condition during propofol induction with low-dose rocuronium in children. The mean arterial pressure and heart rate were higher in the ketamine group after propofol injection but they remained within the normal limit in both groups throughout the study period. |
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