Ketamine - Propofol Combination for Pediatric Procedural Sedation and Analgesia in a Low Resource Setting: an Observational Study

Author(s): Bengono BRS, Jemea B, Metogo Mbengono JA, Amengle AL, Ndikontar R, Kameni Y, Owono EP, Ze Minkande J

Background
Our objective was to evaluate the efficiency and tolerance of the ketamine-propofol combination for procedural sedation and analgesia in children.

Patients and methods
It was a prospective and observational study over 6 months involving children aged 1 to 15 years old, ASA I or II, requiring procedural sedation. The children received an initial dose of the mixture made of ketamine 0.75 mg / kg and propofol 0.75 mg / kg. Variables studied included the indication for sedation, time to sedation onset, duration of sedation, recovery time, adverse effects, tolerance of sedation, efficiency of sedation and practitioner satisfaction. Data collection was carried out using a pre-established form, with. analysis performed using Cspro version 7.4 software. Data was expressed as means, medians, and absolute numbers for quantitative variables, and as percentages for qualitative variables.

Results
Sedation was performed for 46 children. The median age was 3 years. The indications were painful procedures (43.5%) and imaging (34.8%). The median drug dose administered was 0.75 mg / kg of ketamine and propofol (IQR = 0.73 to 0.80 mg / kg). Sedation was adequate in all patients. Minor adverse effects were encountered in 12 children (26.1%), with 8 cases of nystagmus (17.4%) and 2 cases of agitation (4.3%). The mean sedation time was 17 ± 10.4 minutes. The median recovery time was 10 minutes (IQR = 8 to 14.3). The mean time to onset of sedation was 32.2 ± 6.9 seconds. The satisfaction scores were high.

Conclusion
Procedural sedation and analgesia using the ketamine-propofol combination is an interesting and effective option. It presents with minor adverse effects and recovery time is short.