CASE REPORT
Year : 2011  |  Volume : 5  |  Issue : 2  |  Page : 219-222

Dexmedetomidine-ketamine sedation during bone marrow aspirate and biopsy in a patient with duchenne muscular dystrophy


1 Department of Anesthesiology, Nationwide Children's Hospital and the Ohio State University, Columbus, Ohio, USA
2 Department of Anesthesiology and Pediatrics, Nationwide Children's Hospital and the Ohio State University, Columbus, Ohio, USA

Correspondence Address:
Joseph D Tobias
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, The Ohio State University, 700 Children's Drive, Columbus - 43205, Ohio
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.82810

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Sedation during invasive procedures not only provides appropriate humanitarian care for patients, but also facilitates the completion of invasive procedures. Although generally safe and effective, adverse effects may occur especially in patients with co-morbid diseases. We present the successful use of a combination of dexmedetomidine and ketamine to provide sedation and analgesia in a 21-year-old patient with Duchenne muscular dystrophy (DMD) undergoing bone marrow aspiration and biopsy. Co-morbidities included both depressed myocardial function and impaired respiratory function. Dexmedetomidine was administered as a loading dose of 1 μg/kg over 5 min followed by an infusion of 1 μg/kg/h. Ketamine (20 mg) was administered along with the dexmedetomidine loading dose. An additional 10 mg of ketamine was administered to treat the pain experienced during the placement of the local anesthetic agent prior to the procedure. No clinically significant hemodynamic or respiratory changes were noted. The patient tolerated the procedure well and was discharged home. A review of previously published reports of dexmedetomidine and ketamine for procedural sedation are reviewed.


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