COMPARISON OF PROPOFOL-KETAMINE (KETOFOL) AND PROPOFOL-FENTANYL (FENOFOL) FOR SEDATION, RECOVERY AND HEMODYNAMICS IN PEDIATRIC PATIENTS UNDERGOING BURNS DRESSING CHANGE.

Burn injury is one of the leading cause of hospital admissions that have been associated with long term nervous system morbidity particularly for pediatrics population. Chronic persistent pain have been reported in 52% of the respondents that directs the aim at providing adequate analgesia during burn dressing. Multiple modalities have been used to alleviate the pain, anxiety and stress of burn dressing among pediatric patients. Many such modalities include use of music therapy, use of hypnosis, patient control analgesia and distraction techniques . Multiple intravenous analgesic agents have been studied and recommended to use for burn dressing change such as fentanyl, ketamine, tramadol, midazolam, Dexmedetomidine , morphine and satisfactory results have been achieved. We selected pediatric patients age between 5-12 years, having second degree burn of 5-25% requiring burn dressing change. The patients were divided into two groups to receive propofol-ketamine and porpofol-fentanyl according to their weights. Additional porpofol was given to achieve sedation score of 4 and start the procedure. Thourghout the procedure their sedation score, hemodynamics and any adverse effects were noted. Post procedure their recovery scores were recorded in PACU. We found better and early sedation in ketofol group while fenofol group gave better hemodynamics and recovery of the patients. There were no significant adverse effects in both the groups. we concluded that the combinations propofol- ketamine and propofol- fentanyl are satisfactory sedative agents for change of dressings in pediatric burn patients, however combination of PF is superior to PK group for rapid recovery of patient with better hemodynamic profile.