Comparison of Sevoflurane Versus Ketamine for Induction of Anaesthesia in Children

  • Afia Rahna
  • Kiran Ayesha
  • Javeriah Khan Pakistan Institute of Medical Sciences, Islamabad.
  • Rana Imran Sikander PIMS Hospital
  • Naheed Fatima

Abstract

Background and Objective: Induction of general anaesthesia in paediatric patients is a challenging task. Sevoflurane and ketamine both can be used for induction. The purpose of this study was to find out ideal induction agent in paediatric cases. We compared induction time, hemodynamic variation and oxygen saturation with ketamine and sevoflurane in paediatric patients undergoing different surgeries. 

Methodology: A randomized controlled trial was conducted at Department of Anaesthesia Children Hospital, PIMS, Islamabad from December 2018 to May 2019. We enrolled a total of 130 paediatric patients of either gender with age 4-12 years, who were planned for surgery under general anaesthesia. Patients were randomly allocated into two groups for anaesthesia induction. Group S patients received 8% Sevoflurane given via face mask in 100% oxygen at FGF of 6L/min and group K patients received Ketamine 1 mg/kg body weight via intravenous route. Mean time of induction, heart rate response, mean arterial pressure (MAP) response and oxygen saturation after induction was measured at one and two minutes and compared in both groups. All information was recorded via study Proforma and SPSS version 17 was used for data analysis.

Results: Mean age of group S patients was 6.8 years ± 2.9 and in group K patients was 7.3 years ± 2.5 (Ρ=0.372). There were 73.8% males and 26.2% females in group S and 61.5% males and 38.5% females in group K. Mean induction time  in group S patients was 56.2 seconds ± 27.7  and in group K patients was 71.2 seconds ± 37.3  (Ρ=0.011). The induction time was significantly shorter in group S patients as compared to group K patients. At one minute, mean heart rate in group S patients was 112.4 bpm ± 18.8  and in group K patients was 121.9 bpm ± 18.7  (Ρ=0.005). At two minutes, mean heart rate in group S patients was 115.4 bpm ± 17.5  and in group K patients was 123.9 bpm ± 18.8  (Ρ=0.008). At one minute, MAP in group S patients was 60.1 mmHg ± 6.1 and in group K patients was 73.6 mmHg ± 9.2 (Ρ=0.001). At two minutes, MAP in group S patients was 60.4 mmHg ± 6.4 and in group K patients was 76.3 mmHg ± 10.8 (Ρ=0.001).  At one minute, mean oxygen saturation in group S patients was 99.8% ± 0.54  and in group K patients was 99.7% ± 0.44  (Ρ=0.477). At two minutes, oxygen saturation in group S patients was 99.8% ± 0.54 and in group K patients was 99.6% ± 1.53 (Ρ=0.253).

Conclusion: Sevoflurane as an inhalational induction agent is a better choice in children due to shorter induction time and stable hemodynamic response as compared to ketamine, an intravenous induction agent.

Key words: Anaesthesia induction; ketamine; sevoflurane

Published
2025-01-06
Section
Original Articles