Effect of combined versus individual intranasal dexmedetomidine and ketamine on intraocular pressure in pediatric patients | ||
| Egyptian Journal of Anaesthesia | ||
| Volume 40, Issue 1, December 2024, Pages 390-396 PDF (1.09 M) | ||
| DOI: TEJA-2023-0287 | ||
| Authors | ||
| Mona Ahmed Elhadad; Mohamed A Awwad; Mohamed Said Mostafa Elmeligy | ||
| Abstract | ||
| Purpose To compare impact of intranasal infusion of dexmedetomidine, ketamine, or combination of both on IOP in children. Patient & methods This prospective, randomized, observational study was conducted at Benha University Hospital, Egypt and included ASA I or II children aged 1–6 years who underwent examination under sedation. They were randomly divided into three groups: Group D (dexmedetomidine 3 μg/kg); Group DK (dexmedetomidine 1 μg/kg with ketamine 2 mg/kg) & Group K (ketamine 4 mg/kg). We assessed IOP difference before and after sedation. Secondary outcomes were sedation scale assessment (Ramsay Sedation Score), emergency agitation and medication side effects. Results We studied 118 children divided into Group D (36 patients), Group DK (42 patients) & Group K (40 patients). IOP was significantly lower in group D (13 ± 3 mmHg) than in groups DK (16 ± 4 mmHg) and K (17 ± 3 mmHg), with no significant difference between groups DK and K. Ramsay 3 was higher in group K (65%) compared to groups D and DK (22.2% and 9.5%, respectively), while Ramsay 4 was higher in group D and DK (52.8% and 52.4%, respectively) compared to group K (35%). Post-sedation nausea and vomiting were higher in group K (25%) compared to groups D and DK (0% for each). Agitation was higher in group K (62.5%) than in groups D and DK (0% for each) ( < 0.001). Conclusion Intranasal dexmedetomidine and ketamine combination are viable for achieving optimal sedation in pediatric patients undergoing surgeries or medical procedures with no significant change in the IOP. | ||
| Keywords | ||
| Dexmedetomidine; Ketamine; Intraocular Pressure; Pediatric; intranasal; Sedation | ||
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