The effect of alfentanil versus ketamine on the intubation condition and hemodynamics with low-dose rocuronium in children

Abstract

We investigated the effect of alfentanil and ketamine on the intubation condition and hemodynamic parameters during propofol anesthesia with low-dose rocuronium in children. Fifty-four children, aged 3-9 years undergoing tonsillectomy, were randomly allocated to receive either alfentanil 20 mu g/kg (alfentanil group, n = 27) or ketamine 0.5 mg/kg (ketamine group, n = 27) 1 min before anesthesia induction. Anesthesia was induced with propofol 2.5 mg/kg and rocuronium 0.3 mg/kg and maintained with propofol infusion (6 mg/kg/h). The neuromuscular relaxation was monitored, and intubation conditions, hemodynamic changes, and recovery time were assessed. All patients were successfully intubated and there were no significant differences in the intubation conditions between alfentanil and ketamine groups. At the time of tracheal intubation, the median [inter-quartile range] twitch height was similar between two groups (37 [4-48] % in the alfentanil group vs. 29 [4-43.5] % in the ketamine group, p = 0.326). This study showed that both ketamine 0.5 mg/kg and alfentanil 20 mu g/kg provided adequate intubation condition during propofol induction with low-dose rocuronium in children. The mean arterial pressure and heart rate were higher in the ketamine group after propofol injection but they remained within the normal limit in both groups throughout the study period.