Comparison of propofol versus ketamine for anesthesia in pediatric patients undergoing cardiac catheterization

Intravenous propofol was compared with ketamine in 20 pediatric patients undergoing cardiac catheterization. The study patients were randomly assigned to treatment groups so that 10 patients received ketamine and 10 patients received propofol. The hemodynamic responses and recovery characteristics of the two groups were compared. On induction of anesthesia, seven patients in the propofol group experienced a transient decrease in mean arterial blood pressure greater than 20% of baseline accompanied by mild arterial desaturation in four patients. Only one patient in the ketamine group experienced such a decrease in arterial blood pressure. This was the only significant difference (P less than 0.05) in hemodynamic effects between the two groups. Time to full recovery (mean +/- SD) was significantly less in the propofol group (24 +/- 19 min vs 139 +/- 87 min, P less than 0.001). In the ketamine group only, significant correlations (P less than 0.05) included time to full recovery with duration of anesthetic (r = 0.71) and time to full recovery with total drug dose per kilogram (r = 0.82). The authors conclude that propofol anesthesia is a practical alternative for pediatric patients undergoing elective cardiac catheterization and may be preferable to ketamine because of the significantly shorter recovery time.