a Comparive Study of Ketamine-Propofol Versus Dexmedetomidine-Propofol Sedation in Pediatric Patients Undergoing Cardiac Catheterization for Device Closure of Simple Left-to-right Shunts

Exclusion Criteria

• •Cyanotic congenital heart disease
• •Complex congenital cardiac lesions
• •Risk of pulmonary hypertensive crisis
• •Requirement for general anesthesia and cuffed endotracheal tube at the discretion of the cardiology or anesthesia team
• •Baseline oxygen requirement \> 2 L/min
• •Use of noninvasive ventilation
• •Known allergy or intolerance to ketamine, dexmedetomidine, or propofol
• •Significant hepatic impairment
• •Significant renal impairment
• •Advanced atrioventricular block
• •Clinically significant bradyarrhythmia
• •Uncontrolled epilepsy
• •Raised intracranial pressure
• •Severe obstructive sleep apnea
• •Craniofacial anomalies associated with anticipated difficult airway management
• •BMI \> 97th percentile when judged to confer high risk of sedation-related airway obstruction
• •Current beta-blocker use
• •Current clonidine use
• •Acute upper respiratory tract infection within 2 weeks before the procedure
• •Emergency or add-on procedures
• •Anticipated procedure duration \< 20 minutes
• •Anticipated procedure duration \> 3 hours