Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Ketofol Provides Better Upper Airway Size than Ketamine and Propofol in Pediatric Population Receiving Sedation for Magnetic Resonance Imaging
Ketofol Manyetik Rezonans Görüntüleme İçin Sedasyon Alan Pediatrik Hastalarda Ketamin ve Porofole Göre Daha Geniş Havayolu Açıklığı Sağlar
Gülseren YILMAZa, Osman ESENb, Nevin AYDINa, Kenan VAROLc, Arda KAYHANc, Abdurrahim DERBENTd, Ziya SALİHOĞLUe
aUniversity of Health Sciences Faculty of Medicine, Kanuni Sultan Süleyman Hospital Department of Anesthesiology&Reanimation, İstanbul, TURKEY
bİstanbul Oncology Hospital, Department of Anesthesiology & Reanimation, İstanbul, TURKEY
cUniversity of Health Sciences Faculty of Medicine, Kanuni Sultan Süleyman Hospital, Department of Radiology, İstanbul, TURKEY
dEge University Faculty of Medicine, Department of Anesthesiology&Reanimation, İzmir, TURKEY
eİstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Anesthesiology&Reanimation, İstanbul, TURKEY
Turkiye Klinikleri J Pediatr. 2020;29(2):57-64
doi: 10.5336/pediatr.2019-71846
Article Language: EN
Full Text
ABSTRACT
 Objective: The present study aimed to compare the upper airway dimensions as well as hemodynamic and anesthetic features of propofol, ketamine, and ketofol in children undergoing magnetic resonance imaging (MRI) scanning. Material and Methods: This retrospective study was carried out on data derived from a total of 89 patients aged between 1-160 months who were allocated in 3 groups concerning the anesthetic agents administered during sedation for MRI. Group I received ketamine and propofol (ketofol), whereas Group II had propofol and, and Group III received ketamine in this procedure. Results: The cross-sectional area of the upper airway at the levels of the base of tongue, soft palate and epiglottis were higher in patients receiving ketofol, compared to those receiving propofol or ketamin (p<0.05). The duration of the recovery and total duration of the procedure were also significantly lower in patients receiving ketofol compared to others (p< 0.001). Systolic, diastolic, and mean blood pressures were significantly lower in children receiving propofol compared to those receiving ketamine or ketofol. Conclusion: Ketofol, which is the combination of ketamine and propofol, provides an effective and safe anesthetic regimen for magnetic resonance imaging in the pediatric population. Our results show that ketofol-based sedation also provides a larger upper airway size without the development of any hemodynamic derangement.

Keywords: Child; upper airway; sedation; ketofol; magnetic resonance imaging
ÖZET
 Amaç: Bu çalışma, manyetik rezonans görüntüleme (MRG) için sedasyon alan pediatrik hastalarda propofol, ketamin ve ketofolün hava yolu açıklığı, hemodinamik ve anestetik sonuçlar üzerine etiklerini karşılaştırmayı amaçlamaktadır. Gereç ve Yöntemler: Bu retrospektif çalışma MRG için 3 ayrı anestetik ajan ile sedasyon uygulanan, 1-160 ay arasında 89 hastanın verileri kullanılarak gerçekleştirilmiştir. Grup 1 ketamin ve propofol kombinasyonu olan ketofol, Grup 2 propofol, Grup 3 ise ketamin ile sedatize edilmiş hastalardan oluşmaktadır. Bulgular: Ketofol alan hastalarda propofol veya ketamin alanlara göre üst solunum yolu kesitsel alanı dil kökü, yumuşak damak ve epiglottis seviyelerinin tamamında daha genişti (p < 0,05). Derlenme süresi ve toplam prosedür süresi de ketofol grubunda diğer gruplara göre anlamlı olarak kısaydı (p< 0,001). Propofol uygulanan hastalarda işlem boyunca sistolik, diyastolik ve ortalama arter basınçları ketamin ve ketofol gruplarına göre önemli derecede düşüktü. Sonuç: Ketamin ve propofolün kombinasyonu olan ketofol MRG için sedasyon alan pediatrik hastalarda etkin ve güvenli sedasyon sağlar. Çalışmamızın sonuçları ketofol ile sedasyonun hemodinamik bozulmaya neden olmadan daha geniş hava yolu açıklığı sağladığını göstermektedir.

Anahtar Kelimeler: Çocuk; üst solunum yolu; sedasyon; ketofol; manyetik rezonans görüntüleme
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