Korean J Anesthesiol.  1984 Mar;17(1):33-41.

Ketamine Anesthesia for Cardiac Catheterization

• Kim JH
• Bang SO
• Oh HK

Abstract

Cardiac catheterization has been used as an essential diagnostic procedure since 1929 when initiated by Forssman. Anesthesis in an infant will change BP and respiration and thus the diagnostic results may be effected. It is desirable to minimize these effects and still give safe anesthesia. To solve these problems some authors have recently reported on the use of ketamine for anesthesia. Ketamine has simple and rapid induction, easy maintanance of airway and respiration without intubation or extra oxygen supply (Stanley et al, 1969, Coppel and Dundee, 1972). But it causes a rise of BP and pulse rate(Domino et al 1965: Roberts, 1967: Phillips et al, 1970) which may effect the results of catheterization. In the present clinical study to evaluate the effect of ketamine on BP, pulse and pulmonary artery pressure, 47 congenital heart cases were randomly divided into 2 groups. In group l the effect of ketamine on BP EKG and respiration was studied on 37 patients undergoing cardiac catheterization and angilgram. The average age was 4 years with a range from 1/2 to 13 years, and the weight averaged 14kg with a range from 6 to 40kg. In group 2, a cathether was inserted into the main pulmonary artery under local anesthesia and the pressure was measured before and after l.V. ketamine (1mg/kg) in 10 cases in which the age was around 7years(range 3~13 years) and the body weight around 19kg(range 11~32kg). The following results were obtained: 1. Mean blood pressure significantly increased from 82.7+/-1.8mmHg to 91.8+/-2.0mmHg in 1 min. after l.V. ketamine and lasted around 4min. The pulse rate increased from 125.9+/-4.1min. to 131.9+/-4.3min in 1 min. after ketamine and lasted about 2 min. 2. Immediately after angiogram the blood pressure significantly decreased from 111.7+/-2.8/70.0+/-2.3mmHg to 88.0+/-2.4/51.6+/-2.4mmHg in group l. 3. The amin pulmonary artery pressure increased significantly form 41.9+/-7.16/16.4+/-4.8mmHg to 50.8+/-8.7/23.7+/-5.8mmHg. The mean pulmonary artery pressure difference was 8.1+/-0.9mmHg after ketamin I.V. injection and the mean aorta pressure difference at the time was 11.2+/-2.2mmHg in group 2. 4. No. other findings were observed. From the above results, although ketamine obviously raised pulmonary artery pressure and blood pressure during cardiac catheterization, there was no intereference in diagnosing the condition. It suggests that the use of ketamin is a safe method when cardiac catheterisation is performed in children with cardiac problems except when there is severe pulmonary hypertension.

MeSH Terms

Anesthesia*
Anesthesia, Local
Aorta
Blood Pressure
Body Weight
Cardiac Catheterization*
Cardiac Catheters*
Catheterization
Catheters
Child
Electrocardiography
Heart
Heart Rate
Humans
Hypertension, Pulmonary
Infant
Intubation
Ketamine*
Oxygen
Pulmonary Artery
Respiration
Ketamine
Oxygen