الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 135 |  |  |
| | | from | 135 | | |
Abstract
Cardiac catheterization remains the gold standard for detailed diagnosis of complex cardiac anatomic anomalies. Anesthetic management for cardiac catheterization in pediatric patients can be uniquely challenging especially in children with Rt to Lt shunt. In order to obtain meaningful hemodynamic data during cardiac catheterization, it is important to provide stable hemodynamics with no effect on intracardiac shunting and maintain spontaneous ventilation with no supplemental oxygen. Also, it is important that the patients remain immobile during the procedure to avoid cardiac complications, especially perforation .
This study aims to compare between dexmedetomidine-ketamine and propofol-ketamine combinations in pediatric patients undergoing cardiac catheterization as regard:
Hemodynamic effects,
Sedation level during manouver,
Post-manouver recovery period.
Forty-four patients were included in the study, 22 patients in each group. There were no statistically significant differences in age, weight and duration of procedures . With respect to hemodynamic variables, there was no significant differences in systolic arterial blood pressure , and respiratory rate , and oxygen saturation between the two groups . there was mild significant decrease in heart rate in DK group comparing with its basal
values and comparing with other group . Regarding sedation parameters there was significant increase in the additional doses of ketamine consumption. Regarding recovery time, as assessed using the Steward scoring system (Steward score of 6 or higher), and time of discharge criteria to PICU is rapid in the DK group comparing with the PK group . The groups differ significantly including adverse effects during the procedures, as bradycardia more common in DK group and oxygen desaturation more common in PK group.
Conclusions:-
Although all of the two anesthetic techniques were satisfactory, It was concluded that the use of dexamedetomidine in combination with Ketamine anesthesia is a safe, practical alternative for pediatric patients undergoing elective cardiac catheterization and may be preferable to ketamine/ propofol because of the significantly shorter recovery time, without hemodynamic or respiratory effects during the procedure despite being associated with decrease in HR (HR decrease<20% ).