Induction of anaesthesia in cyanotic heart diseases: 'Ketomidate' to the rescue!

Dua, Nupur; Bhalotra, Anju

doi:10.4103/ija.ija_395_17

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Ketamine has long been advocated for induction in patients with TOF physiology as it increases the SVR. Some have proposed a combination as “Ketomidate.” 9 However, in our patient, it had the difficult-to-titrate potential to increase the HR, myocardial oxygen demand, potentially increase pulmonary artery pressures, and, although controversial, potentially increase the intracranial pressure. 10 As the variable coronary anatomy of DORV could not be visualized on echocardiography, we decided to avoid ketamine.…”

Section: Discussionmentioning

confidence: 72%

Neurosurgical Emergency in an Adult With Single Ventricle Physiology: A Case Report

Depuru¹,

Lazar²,

Naik³

et al. 2022

A&A Practice

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The anesthetic management of a patient with uncorrected congenital heart disease presenting for noncardiac surgery is quite challenging. When this becomes a neurosurgical emergency, the need to balance cerebral and complex circulatory physiologies tests the anesthesiologist’s preparedness. The principal clinical challenges we faced were preventing increases in intracranial pressure while maintaining the circulatory physiology using the “cardiac grid” approach to hemodynamic management in a case of acyanotic double outlet right ventricle with a posterior fossa space-occupying lesion. Point of care preoperative echocardiography enabled us to understand the altered circulatory physiology and successfully manage this patient.

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Section: Discussionmentioning

confidence: 72%

Neurosurgical Emergency in an Adult With Single Ventricle Physiology: A Case Report

Depuru¹,

Lazar²,

Naik³

et al. 2022

A&A Practice

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“…Thus it is combined with opioids or propofol. Another recently described alternative to this is Etomidate combined with Ketamine [52].…”

Section: Other Uses Of Ketaminementioning

confidence: 99%

Uses of Ketamine in the Paediatric Population

Ramesh¹

2022

Ketamine Revisited - New Insights Into NMDA Inhibitors

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General anesthesia in pediatric patients can vary from light sedation to complete anesthesia with unconsciousness, amnesia and muscle relaxation. A wide variety of procedures are done under general anesthesia in children ranging from surgeries done for correction of congenital defects, cardiac surgeries, scoliosis surgery, hernia surgery etc. to procedures done outside the operating room (OR) for diagnostic and therapeutic purposes. Non-Operating room Anesthesia (NORA) may include painless procedures like CT scan, MRI, radiotherapy for cancer treatment etc. or painful procedures like biopsy, lumbar puncture, securing IV access, insertion of central line etc. done in ICU which requires a cooperative child. Ketamine has an important role in the pediatric population, both as an induction agent and as a sedative-analgesic drug especially in countries where newer drugs are not readily available. Ketamine helps to alleviate separation anxiety. Even procedures done under regional techniques in some older children require use of sedation. Ketamine can be administered through various routes-IV, IM, intranasal etc. It can be used along with other groups of drugs like Benzodiazepines, Barbiturates, Alpha 2 agonists, Propofol etc. Thus Ketamine is a versatile drug with various indications for use in the pediatric population which will be discussed in the current chapter.

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Induction of anaesthesia in cyanotic heart diseases: 'Ketomidate' to the rescue!

Cited by 2 publications

References 5 publications

Neurosurgical Emergency in an Adult With Single Ventricle Physiology: A Case Report

Neurosurgical Emergency in an Adult With Single Ventricle Physiology: A Case Report

Uses of Ketamine in the Paediatric Population

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