- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02602743
Propofol-Ketamine vs Remifentanyl-Ketamine for Sedation in Pediatric Patients Undergoing Colonoscopy
Ketamine and propofol have been used most frequently agents and remifentanil is used with increasing frequency in recent years. Investigators will compare ketamine-propofol and ketamine-remifentanyl effects on drug consumption, respiration, hemodynamics and recovery in pediatric colonoscopy patients. Our study is a prospective, randomized comparison of ketamine-propofol and remifentanyl-propofol for sedation in pediatric patients during elective colonoscopy. ASA I-II, 2-16 years old, seventy children will be included in the study after ethics committee approval and written informed consent from the parents. Children with cardiovascular, cerebral, pulmonary, renal and hepatic diseases will be excluded from the study. Group I (RK); 2 mg/kg ketamine and 0,25 µg/kg remifentanyl will be administered for induction in 1 minute.Then 0,1 µg/kg/h remifentanyl infusion will be started.
Group II (PK); 2 mg/kg ketamine and 1 mg/kg propofol will be administered for induction and then 1 mg/kg/h propofol infusion will be started. In case of movement, crying, heart rate and systolic blood pressure more than 20% increase from baseline; 0.05 to 0.1 mg / kg of remifentanil will be administered in group I, 0.5-1 mg / kg will be administered propofol in group II. Not enough that case 0.5-1 mg / kg of ketamine will be applied.
The anesthesiologist will continue monitoring after completion of colonoscopy until recovery of full consciousness. A Steward recovery score of 7 will be defined as the end of the recovery time.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Optimal drug combinations for sedation and analgesia for the diagnosis and treatment of interventional procedures performed in pediatric patients still continue to be the main subject of many scientific studies. The drugs used for this purpose have advantages and disadvantages against each other. Ketamine and propofol have been used most frequently agents and remifentanil is used with increasing frequency in recent years. Investigators will compare ketamine-propofol and ketamine-remifentanyl effects on drug consumption, respiration, hemodynamics and recovery in pediatric colonoscopy patients. Our study is a prospective, randomized comparison of ketamine-propofol and remifentanyl-propofol for sedation and analgesia in pediatric patients during elective colonoscopy. ASA I-II, 2-16 years old, seventy children will included in the study after ethics committee approval and written informed consent from the parents. Children with cardiovascular, cerebral, pulmonary, renal and hepatic diseases will excluded from the study. Patients will be divided into two groups randomly. Patients will fast for at least 6 hours and have an i.v. line in place for the duration of sedation and recovery. All patients will be administered 0,5 mg/kg midazolam orally for premedication 30 minutes before the procedure. Heart rate, systolic and diastolic arterial pressure, peripheral oxygen saturation, respiratory rate and Ramsay sedation scores of all of patients will recorded at baseline, after induction and every 5 minutes during the procedure by the anesthesiologist. All of the patients will receive oxygen (2-4 L/min) through a nasal cannula and 10 ml/kg/h crystalloid infusion perioperatively. The level of recovery at the end of the procedure will be evaluated by Steward Recovery Score.
Group I (RK); 2 mg/kg ketamine and 0,25 µg/kg remifentanyl will be administered for induction in 1 minute. Then 0,1 µg/kg/h remifentanyl infusion will be started.
Group II (PK); 2 mg/kg ketamine and 1 mg/kg propofol will be administered for induction and then 1 mg/kg/h propofol infusion will be started.
In case of movement, crying, heart rate and systolic blood pressure more than 20% increase from baseline; 0.05 to 0.1 mg / kg of remifentanil will be administered in group I, 0.5-1 mg / kg will be administered propofol in group II. Not enough that case 0.5-1 mg / kg of ketamine will be applied.
The anesthesiologist will continue monitoring after completion of colonoscopy until recovery of full consciousness. A Steward recovery score of 7 will be defined as the end of the recovery time. Throughout the process and during the postoperative observation, if systolic blood pressure more than 20% decrease from baseline will be applied 0,1 mg/kg ephedrine, if heart rate more than 20% decrease from baseline 0,01 mg/kg atropine will be applied.Colonoscopy time will be recorded. At the end of the procedure, the gastroenterologist will be asked to give a score in terms of ease attempt. (1=poor, 2=moderate, 3=good, 4=excellent) Adverse events will be recorded, including hypotension (decrease in blood pressure by 20% from baseline), hypertension (increase in blood pressure by 20% from baseline), bradycardia (decrease in heart rate by 20% from baseline), and hypoxia (oxygen desaturation with peripheral oxygen saturation <90%). In addition, the need for additional medication and operator satisfaction among will be compared to the among groups.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Adana, Turkey
- Cukurova University Faculty of Medicine Research Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- ASA I-II
- 2-16 years old children
Exclusion Criteria:
- Children with cardiovascular disease,
- Children with cerebral disorder, respiratory disease,
- Children with renal failure
- Children with hepatic failure
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: remifentanyl, ketamine
Experimental:Remifentanyl and ketamine Remifentanyl vial 2 mg, Ketamine vial 500mg/10 mlt by intravenous.
2 mg/kg ketamine and 0,25 µg/kg remifentanyl will be administered for induction in 1 minute.
Then 0,1 µg/kg/h remifentanyl infusion will be started.
|
0,25 µg/kg remifentanyl will be administered for induction in 1 minute.
Then 0,1 µg/kg/h remifentanyl infusion will be started.
Other Names:
2 mg/kg ketamine will be administered for induction in 1 minute.
Other Names:
|
Active Comparator: propofol, ketamine
Active comparator:Propofol and ketamine Propofol injectable emulsion vial 200 mg/20 mlt, Ketamine vial 500mg/10 mlt by intravenous. 2 mg/kg ketamine and 1 mg/kg propofol will be administered for induction and then 1 mg/kg/h propofol infusion will be started. |
2 mg/kg ketamine will be administered for induction in 1 minute.
Other Names:
1 mg/kg propofol will be administered for induction and then 1 mg/kg/h propofol infusion will be started.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Ketamine, remifentanyl, propofol consumption
Time Frame: 1 hour
|
The amount of anesthetic used during colonoscopy will be recorded as milligram/kilogram for each patient.
|
1 hour
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Blood pressure
Time Frame: 1 hour
|
Blood pressure will be followed during colonoscopy and until modified aldrete score will be 9 points.
|
1 hour
|
Hypoxia
Time Frame: 1 hour
|
Hypoxia (oxygen desaturation with peripheral oxygen saturation <90%) will be followed during colonoscopy and until modified aldrete score will be 9 points.
|
1 hour
|
Heart rate
Time Frame: 1 hour
|
Heart rate will be followed during colonoscopy and until modified aldrete score will be 9 points.
|
1 hour
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Dilek Özcengiz, Prof, Çukurova university
- Study Chair: Çağatay Küçükbingöz, Asistant dr, Çukurova university
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Postoperative Complications
- Delayed Emergence from Anesthesia
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anesthetics, Dissociative
- Anesthetics, Intravenous
- Anesthetics, General
- Anesthetics
- Excitatory Amino Acid Antagonists
- Excitatory Amino Acid Agents
- Analgesics, Opioid
- Narcotics
- Hypnotics and Sedatives
- Ketamine
- Remifentanil
- Propofol
Other Study ID Numbers
- PRK01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Delayed Emergence From Anesthesia
-
Federal University of Minas GeraisBaxter Healthcare Corporation; Medtronic - MITGCompletedDelayed Emergence From Anesthesia
-
Seoul National University HospitalCompletedDelayed Emergence From AnesthesiaKorea, Republic of
-
Nicoleta StoiceaCompletedDelayed Emergence From AnesthesiaUnited States
-
University Medicine GreifswaldDepartment of Anesthesiology, Hospital Dresden-Friedrichstadt, Dresden, GermanyCompletedDelayed Recovery From AnaesthesiaGermany
-
Ruhr University of BochumCompletedDelayed Recovery From Anesthesia
-
Guizhou Provincial People's HospitalCompletedDelayed Emergence From Anesthesia | C.Delivery; Surgery (Previous), Gynecological | Inappropriate Device Stimulation of Tissue
-
Oslo University HospitalRecruitingPostoperative Complications | Cognitive Dysfunction | Delayed Emergence From AnesthesiaNorway
-
University of Sao Paulo General HospitalRecruitingAwakening, Post-Anesthesia DelayedBrazil
-
Corporacion Parc TauliUnknownConfusion | Delayed Emergence From Anesthesia | Delirium, Cause Unknown | Disorientation on EmergenceSpain
-
Beth Israel Deaconess Medical CenterVRHealth Group LtdCompletedPain, Postoperative | Satisfaction | Anesthesia, Intravenous | Delayed Recovery From Anesthesia | Relaxation TherapyUnited States
Clinical Trials on Remifentanyl
-
University Hospital, ToulouseCompletedAnaesthetic InductionFrance
-
The University of Texas Health Science Center,...TerminatedChronic RhinosinusitisUnited States
-
University of PatrasUnknown
-
Azienda Ospedaliera San Gerardo di MonzaCompletedAnesthesia | Craniotomy | NeurosurgeryItaly
-
NovartisCompleted
-
Assistance Publique - Hôpitaux de ParisUnknown
-
Ankara UniversityCompleted
-
Centre Hospitalier Universitaire de Saint EtienneCompleted
-
National and Kapodistrian University of AthensSaint Savvas Anticancer HospitalCompleted
-
Veeda OncologyBausch Health Americas, Inc.TerminatedNausea and VomitingUnited States