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Hemodynamic Effects of Ketamine in Children with Congenital Heart Disease

Departments of Anesthesia and Pediatrics, Division of Cardiology, University of Washington School of Medicine, The Children's Orthopedic Hospital, Seattle, Washington 98105.

Abstract

Pulmonary and systemic vascular responses to ketamine (2 mg · kg^–1, intravenously) were studied during cardiac catheterization in 20 children with congenital heart lesions. Pulmonary and systemic resistances (Rp, Rs), ratios between pulmonary and systemic flows (p/s), and left to right (L R) and right to left shunts (R L) were calculated before and after ketamine administration. Statistically significant (P < 0.05) but clinically minor increases in heart rate (106.8 to 109.9 beats/min), mean pulmonary artery pressure (20.6 to 22.8 mm Hg), and Rp/Rs (0.12 to 0.14) were seen after ketamine. There were no significant changes in systemic arterial pressure, Rs, p/s, L R, R L, or arterial oxygen or carbon dioxide tensions. No patient had any major untoward effects from ketamine administration. It is concluded that the hemodynamic alterations after ketamine administration in children undergoing cardiac catheterization are small and do not alter the clinical status of the patients or the information obtained by cardiac catheterization.

Key Words: ANESTHETICS • INTRAVENOUS-ketamine • HEART—congenital defects • ANESTHESIA—pediatric

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999