To compare the safety and efficacy of propofol- versus ketamine-based analgosedation in children undergoing PDL therapy, with a primary focus on respiratory depression and overall patient outcomes.
Key Findings:
Respiratory depression occurred more frequently in the propofol group (19.5%) compared to the ketamine group (2.6%), p < 0.01, indicating a significant safety concern.
Ketamine was associated with higher rates of hypertension, tachycardia, psychomimetic effects, and postoperative nausea/vomiting, p < 0.01, suggesting a need for careful monitoring.
Propofol was linked to more hypotension, highlighting its risks in certain patient populations.
Sedation and recovery times were longer with ketamine, p < 0.01, which may affect procedural efficiency.
A procedural duration ≥13.5 min predicted respiratory depression in the propofol group (AUC 0.755), emphasizing the importance of procedure length in anesthetic choice.
Interpretation:
Both propofol and ketamine are effective for analgosedation in pediatric PDL therapy. However, propofol poses a higher risk of respiratory depression, especially in longer procedures, while ketamine offers more respiratory stability but with other adverse effects that must be considered.
Limitations:
The anesthesiologist administering the drugs was not blinded, which may introduce bias.
Exclusion of children with certain congenital disorders may limit generalizability of the findings.
Conclusion:
Anesthetic selection should be individualized based on procedural duration and patient risk factors, balancing the benefits and risks of each agent to optimize patient safety and outcomes.
