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Comparison of propofol and ketamine induced anatomical upper airway changes in children at magnetic resonance imaging.

Pelin Karaaslan, Arash Pirat, Erkan Yildirim, Muhtesem Agildere, Gulnaz Arslan

Background: Children are susceptible to airway obstruction with sedative agents because of smaller dimensions of their airways. The aim of our study was to localize and compare propofol versus ketamine induced morphologic upper airway changes in children using the MRI.

Patients and methods: 44 children with ASA physical status class I or II, aged 1-4 years, scheduled for elective MRI of the head were enrolled into this study. Each patient was randomly allocated to either propofol (Group P) or ketamine (Group K) groups. T1 weighted axial slices were used to measure the minimal anterior posterior and transverse diameters of the pharynx at the level of either the dorsum of the tongue or at the level of the soft palate and measurements were compared between the groups.

Results: There were no significant differences among the two groups with respect to age, weight or gender. The cross-sectional area was smallest at the level of soft palate in 32 (72.7 %) children and smallest at the level of tongue in 12 (27.3 %) children. The groups did not differ with regard to the place of the narrowest level, the anteroposterior diameter, the transverse diameter and area of the narrowest sites.

Conclusion: The results suggest that the patients in either group did not differ with regard to the place of the narrowest level, the anteroposterior and transverse diameters and area of the narrowest site of their upper airways. However, tongue was shown to become an important cause of impaired airway patency in anesthetized children.