Abstract:
Background: There is no ideal anesthesia protocol to perform short invasive procedures in pediatric oncology. The combination of propofol and ketamine may offer advantages over propofol alone. Methods: In a prospective, randomized, double-blind study, we analyzed 63 consecutive procedures performed in 47 oncology children. All patients received 1 μg-kg fentanyl, followed by propofol 1 mg-kg in group P (n=33) or propofol 0.5 mg-kg and ketamine 0.5 mg-kg in group PK (n=30) for the initiation of anesthesia. The need for supplementation with propofol and-or fentanyl to maintain an adequate level of anesthesia was recorded. The hemodynamic and respiratory profile, recovery time and the occurrence of side effects were compared. Results: Significantly more children required propofol (100percent vs. 83.3percent) and fentanyl (75.5percent vs. 43.3percent) rescue doses, and developed hypotension (63.6percent vs. 23.4percent) and bradycardia (48.5 vs. 23.4percent) in group P compared with group PK, with a comparable incidence of respiratory adverse events and recovery times. However, 40percent of children in group PK were agitated following recovery compared with 6percent in group P. Conclusions: The combination of propofol and ketamine for invasive procedures in pediatric oncology resulted in reduced propofol and fentanyl consumption and preserved hemodynamic stability, but more children in the combination group recovered with agitation. © 2008 The Authors.