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Erschienen in:
01.06.2012 | Original Article
IV paracetamol effect on propofol–ketamine consumption in paediatric patients undergoing ESWL
Erschienen in: Journal of Anesthesia | Ausgabe 3/2012
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Purpose
Electroshock wave lithotripsy (ESWL) is a painful procedure performed with sedoanalgesia in paediatric patients. The propofol–ketamine combination may be the preferable anaesthesia for this procedure, and propofol–ketamine consumption may be decreased with the administration of intravenous (IV) paracetamol. In this study we investigated the effect of IV paracetamol administration on propofol–ketamine consumption, recovery time and frequency of adverse events in paediatric patients undergoing ESWL.
Methods
Sixty children, ranging in age from 1 to 10 years and with American Society of Anesthesiologists Physical Status 1–2, were included in this prospective, randomized, double-blinded study. Thirty minutes prior to the procedure children randomly assigned to Group I received IV 15 mg/kg paracetamol, and those randomly assigned to Group II received 1.5 mL/kg IV saline infusion 30 min. The propofol–ketamine combination was prepared by mixing 25 mg propofol and 25 mg ketamine in a total 10 mL solution in the same syringe. After the administration of 0.1 mg/kg midazolam and 10 μg/kg atropine to both groups and during the procedure, the propofol–ketamine combination was administered at 0.5 mg/kg doses to achieve a Wisconsin sedation score of 1 or 2. Oxygen saturation and heart rate were recorded at 5-min intervals. Propofol–ketamine consumption, recovery times and adverse events were also recorded.
Results
Demographic data were similar between groups. Propofol–ketamine consumption (Group I, 25.2 ± 17.7 mg; Group II, 35.4 ± 20.1 mg; p = 0.04) and recovery times (Group I, 19.4 ± 7.9 min; Group II, 29.6 ± 11.4 min; p < 0.0001) were significantly different between groups. Saturation, heart rate and adverse events were similar in both groups.
Conclusion
Our data suggest that the administration of IV paracetamol decreases propofol–ketamine consumption for adequate sedation during ESWL procedures in paediatric patients and shortens recovery time.