S-Ketamine for coinduction of general anaesthesia

Abstract

A total of 44 premedicated ASA physical status I or II adult patients, sheduled for elective laparoscopic cholecystectomy participated in this double-blind study. Patients were randomly assigned to two groups of 22 patients each. Group K received for induction of anaesthesia a combination of Midazolam 15 μg/kg, Fentanyl 2 μg/kg, Droperidol 15 μg/kg and after one minute Propofol 1 mg/kg, S-Ketamine 0.4 mg/kg and Atracurium 0.5 mg/kg. The second group of 22 patients, Group P, received Propofol l.5 mg/kg for induction instead of S­Ketamine. Induction of hypnosis was monitored by eyelash reflex time. SBP, DBP, MBP and HR were recorded at one minute intervals starting with 5 minutes prior to intubation and 10 minutes after intubation. SpO2, ETCO2 and ET Isoflurane at one minute intervals were recorded after intubation.
The study groups were not significantly different with respect to demographic data or ASA physical status. The results showed that the hypnosis was more rapidly induced in Group K – 13.9±5.8 sec. in comparison with Group P – 25.77±9sec. (p<0.05). The Group K patients were more hemodynamically stable than the patients from Group P, MBP after Propofol administration was 72.8±6.8 mmHg in group K and 66.4±12.1 in Group P (p<0.05). It was necessary to supplement analgesia with Fentanyl in 13 (59%) patients from Group P (p<0.01) and no patient in Group K.
The use of S-Ketamine in induction helps in achieving a rapid hypnosis and has a good analgesic effect. Also, the sympatolytic effect of propofol is counteracted by S-Ketamine, assuring a stable hemodynamic condition.

Key words: co-induction, S-Ketamine, propofol, hemodynamic stability

Jumalul Român de Anestezie Terapie intensivă 2003 Vol.10 Nr.2, 120-124

Avantajele utilizării S(+) ketaminei la co-inducţia anesteziei generale