Comparative Evaluation of Regain of Consciousness in Dexmedetomidine–Propofol versus Ketamine–Propofol in the Pediatric Cardiac Catheterization Procedure under Sedation using BIS Monitoring: A Randomized Prospective Study

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dc.contributor.authorBanga, Priyaen_US
dc.contributor.authorNegi, Sunder L.en_US
dc.contributor.authorMandal, Banashreeen_US
dc.contributor.authorBarwad, Paragen_US
dc.contributor.authorSaini, Kulbhushanen_US
dc.contributor.authorGourav, Krishna P.en_US
dc.date.accessioned2025-06-18T10:05:34Z
dc.date.available2025-06-18T10:05:34Z
dc.date.issued2025-03
dc.description.abstractBackground: Congenital heart diseases (CHDs) are not rare and often require an intervention at some point of time. Pediatric cardiac catheterization, a minimally invasive procedure, is performed to diagnose and to correct many cardiac abnormalities. Deep sedation with spontaneously breathing patients is the preferred technique for pediatric catheterization in the pediatric population. Therefore, the author aimed to find the best combination of drugs for pediatric cardiac catheterization procedures using dexmedetomidine–propofol (DP) and ketamine–propofol (KP). Materials and Methods: Cyanotic and acyanotic CHD children, weighing 5–20 kg and undergoing sedation for cardiac catheterization, were randomly assigned into two groups. DP group children received a bolus intravenous (IV) propofol at 1 mg/kg body weight followed by 1 mcg/kg dexmedetomidine over 10 minutes. KP group children received a bolus IV propofol 1 mg/kg followed by ketamine 1 mg/kg over 10 minutes. For maintenance in the DP group, propofol infusion at 1.5 to 2 mg/kg/h and dexmedetomidine at 0.5 mcg/kg/h was started. In the KP group, propofol infusion at 1.5 to 2 mg/kg/h and ketamine at 1 mg/kg/h was started as maintenance. The bispectral index (BIS) was monitored throughout the procedure, and the BIS value was maintained between 60 and 80. Propofol top of 1 mg/kg was administered when the BIS value became more than 80 or when the child moved during the femoral vessel puncture or when the child moved during the procedure. Results: The mean time for regain of consciousness was faster ( P < 0.005) in the KP group (11.02 ± 11.98) compared to the DP group (21.62 ± 18.68). BIS was monitored throughout the procedure; BIS values were lower ( P < 0.001) in the DP group (60.0 ± 11.1) as compared to the KP group (73.7 ± 5.6). The cumulative doses of propofol in the KP group and DP group were comparable. Total fentanyl consumptions in the intraoperative period in the KP group and DP group were comparable ( P > 0.001). There was no difference in drug side effects between the groups. Conclusion: The KP combination had fast and early recovery compared to the DP combination in children who underwent the cardiac catheterization procedure under sedation in children undergoing cardiac catheterization procedures requiring sedation.en_US
dc.identifier.affiliationsDepartment of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.citationBanga Priya, Negi Sunder L., Mandal Banashree, Barwad Parag, Saini Kulbhushan, Gourav Krishna P..Comparative Evaluation of Regain of Consciousness in Dexmedetomidine–Propofol versus Ketamine–Propofol in the Pediatric Cardiac Catheterization Procedure under Sedation using BIS Monitoring: A Randomized Prospective Study.Annals of Cardiac Anaesthesia.2025 Mar;28(1):33-38en_US
dc.identifier.issn0971-9784
dc.identifier.issn0974-5181
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/247983
dc.languageenen_US
dc.publisherWolters Kluwer – Medknowen_US
dc.relation.issuenumber1en_US
dc.relation.volume28en_US
dc.source.urihttps://doi.org/10.4103/aca.aca_19_24en_US
dc.subjectBispectral indexen_US
dc.subjectdexmedetomidine–propofolen_US
dc.subjectketamine–propofolen_US
dc.subjectpediatric cardiac catheterizationen_US
dc.subjectregain of consciousnessen_US
dc.titleComparative Evaluation of Regain of Consciousness in Dexmedetomidine–Propofol versus Ketamine–Propofol in the Pediatric Cardiac Catheterization Procedure under Sedation using BIS Monitoring: A Randomized Prospective Studyen_US
dc.typeJournal Articleen_US
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