A comparison of the behavioral effects of ketamine and propofol sedation in the pediatric endoscopy unit

Abstract

Introduction: Hospitalization and anesthesia can have a harmful psychological impact on children, leading to behavioral abnormalities. Using the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS) version of the Post Hospitalization Behavior Questionnaire for daycase patients, the objective of this study is to assess the differences between ketamine and propofol and propofol alone use following anesthesia. Materials and methods: After receiving approval from the ethics committee, 84 children ages 2 to 18 who would undergo sedation surgery at the pediatric endoscopy-colonoscopy unit at Ankara City Hospital were enrolled in the study. Group K consisted of 27 patients sedated with ketamine and propofol, while group P consisted of 57 children sedated with propofol. To detect postoperative behavioral alterations in these youngsters, a questionnaire (POBQ-AS) was administered soon prior to the procedure and on the third day following it. Results: Pre-procedural Behavior Assessment Questionnaire Total scores were comparable for both groups. The measures on the third day following the surgery were also comparable. The Post-procedure Behavior Evaluation Questionnaire Total Score increased significantly (p 0.05) in both groups compared to the pre-procedure score. In Group K, the answers to the questions "Is he disconnected to his environment?" and "Does he become depressed when left alone?" increased significantly more than in the other group (p 0.05). Conclusion: Pediatric perioperative behavioral problem may be common. On the third postoperative day, sedative applications involving ketamine and propofol induce detrimental behavioral alterations, according to this study. In our patient group selected from the endoscopy unit to exclude factors such as mask induction, muscle relaxants, inhalation anesthetics, and surgical incision pain, we believe that only the negative behavioral changes of the intravenous anesthetics ketamine and propofol, as well as factors such as inflammation, surgical stress, and neurotoxicity, should be the focus of future research.