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Comparison of TIVA with different combinations of ketamine–propofol mixtures in pediatric patients

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Abstract

Purpose

Adding ketamine to propofol has been suggested to be useful for sedation and general anesthesia. This study aimed to determine the effect of TIVA with different ratios of ketofol on recovery in children.

Methods

Seventy-five children aged 3–12 years and undergoing adenoidectomy and/or tonsillectomy surgery were randomized into three groups. Ratios of 1:5, 1:6.7 and 1:10 ketamine–propofol mixture (ketofol) were prepared in the same syringe for groups I, II and III, respectively. Induction and maintenance of anesthesia were performed with 1:5, 1:6.7 and 1:10 ratios of ketofol in groups I, II and III, respectively. A McFarlan infusion dose regimen was used (15 mg/kg/h for 15 min, 13 mg/kg/h for 15 min, 11 mg/kg/h for 30 min) and infusion rates were decreased for the different ratios. Infusion rates were reduced to 67, 80 and 90% of the McFarlan dose regimen for groups I, II and III, respectively. Extubating time, length of stay in PACU, postoperative PAED and FLACC scores were recorded.

Results

Extubating time was significantly lower [mean 254.3 ± 92.7 s (95% CI 216.6–292.6, p = 0.001)] in group III than in groups I and II [371.3 ± 153 s (308.1–434.48) and 343.2 ± 123.7 s (292.2–394.3), respectively]. Length of stay in the PACU was lower in group III [median 15 min (interquartile range 15–20, p = 0.001)] than in groups I and II: 20 (15–27.5) and 20 min (20–27.5), respectively.

Conclusion

TIVA with a 1:10 ratio of ketofol admixture with a 90% reduction of McFarlan regimen can provide improved recovery conditions.

Trial registration

ClinicalTrials.gov identifier: NCT02848963.

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Acknowledgements

Assistance with the special article: the authors would like to thank to Scribendi Customer Service (access code w2scP7JDQDHx, order 442107) for English editing of this study.

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Authors and Affiliations

  1. Department of Anesthesiology and Reanimation, Faculty of Medicine, Cukurova University, 01330, Sarıçam, Adana, Turkey

    Ebru Biricik, Feride Karacaer, Ersel Güleç, Murat Ilgınel & Dilek Özcengiz

  2. Department of Head and Neck Surgery, Faculty of Medicine, Çukurova University, Sarıçam, Adana, Turkey

    Özgür Sürmelioğlu

Authors
  1. Ebru Biricik
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  2. Feride Karacaer
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Correspondence to Ebru Biricik.

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Financial support and sponsorship

This study funded by Çukurova University Department of Scientific Research Projects, Project ID 6177, approval date 3 March, 2016.

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The authors have no conflict of interest in relation to the content and recommendations provided in this manuscript.

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Biricik, E., Karacaer, F., Güleç, E. et al. Comparison of TIVA with different combinations of ketamine–propofol mixtures in pediatric patients. J Anesth 32, 104–111 (2018). https://doi.org/10.1007/s00540-017-2438-8

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  • DOI: https://doi.org/10.1007/s00540-017-2438-8

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