Evaluating the effectiveness of ketamine plus atropin as anesthesia for intrathecal chemotherapy and bone marrow procedure at Hue central hospital, Vietnam

Tạp chí Y học lâm sàng Bệnh viện Trung Ương Huế - Số 56 - Trang 3-7 - 2019
Pham Nhu Hiep, Tran Kiem Hao, Nguyen Thi Kim Hoa, Chau Van Ha, Phan Canh Duy, Nguyen Huu Son, Kazuyo Watanabe, Bui Ngoc Lan

Tóm tắt

ABSTRACTBackground: Ketamine is a phencyclidine and cyclohexamine derivative. Ketamine and atropine have been increasingly used in recent years as an effective form of deep sedation/anaesthesia in children in developed countries, but not in developing countries like Vietnam. Objective: This pioneer trial aimed to evaluate the effectiveness of using ketamine plus atropine as anaesthetic agents for paediatric oncology procedures. From this study, we establish a protocol for anaesthesia in paediatric oncology procedures. Methods: A descriptive and prospective study on 223 paediatric patients of both sexes (129 males and 94 females) aged 7.2 months to 15 years (mean age: 4.0 ± 3.4 years) and with body weight between 6.5 to 55 kg (mean weight: 15.3 ± 6.2 kg) was carried out from January 2015 to June 2019. The patients had been diagnosed with acute leukaemia, lymphoma or solid tumor. They underwent intrathecal chemotherapy and bone marrow aspirations or bone marrow biopsy for diagnostic as well as therapeutic purposes. After obtaining informed consent from their parents, the research was performed. Datas were analysed by Medcalc software.Results: The total number of procedures was 810. Bone marrow aspiration was performed 402 times, bone marrow biopsy was done 30 times and intrathecal chemotherapy given 378 times. All procedures were successfully completed. The mean dose of ketamine and atropine used 1.55 ± 0.31 mg/kg and 0.100 ± 0.029 mg respectively. The recovery time was 9.2 ± 7.3 minutes. Only 0.12% experienced apnoea; 1.2% muscular hypertonicity; 4.3% nystagmus, and hyperactivity; 3.7% hypersalivation, 2.5% hallucination and 5.5% vomiting; none of the patients had laryngospasm or transient rash. All of the patients’ parents were satisfied with the use of anaesthetics. Conclusions: This is a pioneer trial for children in Vietnam. The dose of 1.5 mg/kg intravenous ketamine and 0.1mg atropine were found to be effective and suitable dose in children requiring deep sedation for painful procedures and produce only minimal side effects. We established a protocol with the above doses and continue to apply this in order to reduce pain, trauma, and complications during the procedures.

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Tài liệu tham khảo

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Tạp chí Y học lâm sàng Bệnh viện Trung Ương Huế

Số 56

3-7

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