ORIGINAL ARTICLE
Year : 2017  |  Volume : 11  |  Issue : 1  |  Page : 1-7

A comparison between the effect of ketamine versus dexmedetomidine infusion on the frequency of spells during Fallot repair: a randomized controlled trial


Department of Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
Mohamed Elayashy
7 El-Shishiny Street, El-Maryotia, Faisal, Giza - 12131
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejca.ejca_5_17

Rights and Permissions

Background Patients with tetralogy of Fallot experience changes in the dynamics of right ventricular outflow tract obstruction, or changes in systemic vascular resistance cause a decrease in the systemic arterial oxygen saturation. Dexmedetomidine use is not yet approved in pediatric patients, but its effects have been studied in pediatric patients during cardiac surgery, which showed a decrease in the incidence of arrhythmias after bypass. In this study, we postulate that dexmedetomidine may have potential benefits on the pulmonary vascular resistance, which may play a role in decreasing the incidence of tet spells during Fallot repair. Patients and methods This randomized controlled study was conducted in Cairo university pediatric hospitals, where patients were randomly allocated to two equal groups, 30 patients in each group between 6 months and 12 years of age. Patients were allocated to two groups to receive two different anesthesia maintenance regimens: group 1 (the ketamine group, n=30) received isoflurane 0–1% together with ketamine infusion 1 mg/kg/h, and group 2 (the dexmedetomidine group, n=30) received isoflurane 0–1% together with dexmedetomidine 0.25 μg/kg/h. Mean arterial pressure, heart rate, and oxygen saturation were recorded. Arterial blood gases, glucose and lactate levels, and number of tet spells, which is the primary outcome in our study, were evaluated. Results Our primary finding was the number of spells, which was 2 (range: 0–4) in the KET group compared with 0 (range: 0–2) in the DEX group (P<0.001). Intraoperative heart rate decreased more in the DEX group than in the KET group at all times of measurement but with a significant difference at T2 and T3. Mean arterial pressure also decreased in the DEX group with a significant difference between the two groups at T1, T2, and T3. Conclusion Dexmedetomidine infusion as an adjuvant to anesthesia decreased the number of spells in the prebypass period significantly better than ketamine infusion in children undergoing Fallot repair.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed57    
    Printed0    
    Emailed0    
    PDF Downloaded19    
    Comments [Add]    

Recommend this journal