IngentaConnect Single bolus of intravenous ketamine for anesthetic induction dec...

Authors: Choi; Lee; Kim¹; Kwon¹; Shin

Source: Acta Anaesthesiologica Scandinavica, Volume 51, Number 6, July 2007 , pp. 759-762(4)

Abstract:

Background:

Oculocardiac reflex (OCR) is a major complication of pediatric strabismus surgery. The aim of the present study was to determine whether a single bolus of intravenous (i.v.) ketamine for anesthetic induction can decrease OCR in children undergoing strabismus surgery. Methods:

One hundred and twenty healthy children undergoing strabismus surgery were allocated to three groups using double-blind randomization. Anesthesia was induced with propofol 3 mg/kg in Group P, ketamine 1 mg/kg in Group K1, or ketamine 2 mg/kg in Group K2. Anesthesia was maintained with 3% sevoflurane in 50% N₂O/O₂ in all patients. The baseline heart rate was obtained 30 s prior to the first traction of the extraocular muscle (EOM). OCR was defined as a development of arrhythmia or a decrease of more than 20% of the baseline heart rate during EOM traction. Results:

The incidence of OCR was significantly lower in the ketamine groups (4/40 and 1/40 in Group K1 and K2, respectively) compared with the propofol group (14/40). Conclusion:

A single bolus of i.v. ketamine 1 or 2 mg/kg for anesthetic induction results in a lower incidence of OCR than propofol when combined with sevoflurane for maintenance in children undergoing strabismus surgery.

Keywords: Ketamine; oculocardiac reflex; strabismus surgery

Document Type: Research article

DOI: 10.1111/j.1399-6576.2007.01329.x

Affiliations: 1: Department of Anesthesiology and Pain Medicine

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Single bolus of intravenous ketamine for anesthetic induction decreases oculocardiac reflex in children undergoing strabismus surgery