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Anaesthesiology Intensive Therapy
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4/2019
vol. 51
 
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abstract:
Original article

Comparison of propofol-ketamine versuspropofol-remifentanil in children anaesthetized for gastroscopy

Maria Damps
1
,
Ludwik Stołtny
1
,
Jadwiga Siemek-Mitela
1
,
Andrzej Lekstan
2
,
Łukasz Krzych
3
,
Ewa Kucewicz-Czech
4

  1. Department of Anaesthesiology and Intensive Care, Upper Silesian Child Health Centre, Katowice, Poland
  2. Department of Surgery, Vascular Surgery and Transplantation, Medical University of Silesia, Katowice, Poland
  3. Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland
  4. Department of Cardiac Anaesthesia and Intensive Therapy, Medical University of Silesia, Katowice, Poland
Anaesthesiol Intensive Ther 2019; 51, 4: 262–267
DOI: https://doi.org/10.5114/ait.2019.88185
Online publish date: 2019/09/25
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Background
The search for ideal anaesthesia is still an open research issue. The aim of the study was to evaluate and compare two methods of general anaesthesia with preserved own breath – propofol with ketamine and propofol with remifentanil – in children anaesthetized for gastroscopy.

Methods
The study included 90 children enrolled for elective endoscopy of the upper gastrointestinal tract under general anaesthesia. The patients were randomized to one of two groups: Group K consisted of children anesthetized with propofol and ketamine, Group R included children anesthetized with propofol and remifentanil. Parameters monitored during anaesthesia were induction time, respiratory and circulatory parameters, adverse events, waking time and the child’s condition after regaining consciousness.

Results
The groups differed significantly in time of induction of anaesthesia (Group K 3 ± 1 min vs. Group R 4 ± 2.5 min; P < 0.001), waking time (Group R 4 ± 4.5 min vs. Group K 6 ± 5 min; P < 0.01), condition of the child after regaining consciousness (Group R 90.9% calm, Group of K 54% confused; P < 0.001) and evaluation of test conditions in the opinion of the gastroenterologist (in favour of Group K; P < 0.05).

Conclusions
Both methods of anaesthesia presented in the paper are safe and can be used in children to perform endoscopy. Combining propofol with ketamine allows fast induction of anaesthesia and creates very good conditions for the examination. Combining propofol with remifentanil allows fast and full return of consciousness after anaesthesia.

keywords:

gastroscopy, anaesthesia, paediatrics, paediatric anaesthesia
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