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Ketamine-Propofol vs Ketamine-Dexmedetomidine Combinations in Pediatric Patients Undergoing Burn Dressing Changes

Canpolat, Dilek Gunay MD*; Esmaoglu, Aliye MD; Tosun, Zeynep MD; Akn, Aynur MD†ı; Boyaci, Adem MD; Coruh, Atilla MD

doi: 10.1097/BCR.0b013e3182504316
Original Articles

The aim of this study was to compare ketamine-propofol (KP) and ketamine-dexmedetomidine (KD) combinations for deep sedation and analgesia during pediatric burn wound dressing changes. After obtaining approval from the University Ethics Committee, burn wound care or wound dressing changes were performed on 60 American Society of Anesthesiologists physical status I and II inpatients aged between 8 and 60 months with second-degree burns ranging from 5 to 25% TBSA. After recording the demographic data, the heart rate, systolic arterial pressure, diastolic arterial pressure, peripheral oxygen saturation, respiratory rate, and Ramsey sedation scores were recorded for all patients before and during the procedure. Group KP (n = 30) received 1 mg kg−1 ketamine + 1 mg kg−1 propofol and group KD (n = 30) received 1 mg kg−1 ketamine + 0.5 µg kg−1 dexmedetomidine for induction. Additional propofol (1 mg kg−1) for group KP and additional dexmedetomidine (0.5 µg kg−1) for group KD were administered when required. No statistically significant differences in sedation scores and peripheral oxygen saturation and diastolic arterial pressure (P > .05) were found between the two groups. However, systolic blood pressure values in group KD showed a significant increase after induction (P < .05). The recovery time was longer in group KD than in group KP (P < .05). The respiratory rate was higher in group KD than in group KP beginning from the fifth minute of the procedure. A significant amount of respiratory depression and hypoxia was observed in group KP but not in KD (P < .05). Both the KP and KD combinations were effective for sedation and analgesia during dressing changes in the pediatric burn patients. The KD combination can be considered as an excellent alternative for pediatric wound dressing changes which does not result in respiratory depression.

From the *Department of Anesthesiology, Kayseri Education and Research Hospital, Kayseri, Turkey; and Departments of Anesthesiology and Intensive Care and Plastic Aesthetic and Reconstructive Surgery and Burn Unit, Medical Faculty, Erciyes University, Kayseri, Turkey.

Address correspondence to Prof. Dr. Aliye Esmaoglu, Department of Anesthesiology and Intensive Care, Medical Faculty, Erciyes University, Kayseri, Turkey. Email:

© 2012 The American Burn Association