Low Dose Ketamine Given Intravenously During Total Intravenous Anesthsia Of Propofol

Objective To compare the dosage of fentanyl and propofol, delirium, nightmares and hallucinations when ketamine given with no ketamine given intravenously during total intraveneous anesthesia of propofol.Methods Thirty patients(ASA grade â… -â…¡) undergoing elective abdominal surgery were randomly divided into three groups(n=10 each): propofol group(group P), ketamine I group(group K₁) and ketamine â…¡ group (group K₂). For all patients, anesthesia was induced with target control infusion with propofol at 2μg/ml at the beginning, fentanyl 3μg · kg^-1 and vecuronium 0.12mg · kg^-1;and followed with dosage of fentanyl at 2³Î¼g · kg^-1· h^-1, vecuronium 0.06mg · kg^-1 at an interval of 45⁶0min and adjust target concentration according to BIS values. In group P, group K₁ and group K₂, anesthesia was induced with normal saline 5ml, ketamine0.2mg/kg and ketamine0.4mg/kg;and followed with normal saline 1ml · kg^-1 · h¹, ketamine0.5mg · kg^-1· h^-1 and ketamine1mg · kg^-1 · h^-1. In group K1 and group K2 ketamine was no longer used from closing peritonaeum of the operation. BIS values was maintained at 45-60during the majority of the opereation process whereas 60-70 near the end of the operation. ECG, HR, MAP, PetCO₂ BIS and target-effect propofol concentration were continuously monitored. The dosage of fentanyl , target concentration of propofol and time of emergence from anesthesia and extubation were recored in each group. Awareness, delirium nightmares and hallucinations were recorded the next day.Results (1) The dosage of fentanyl was lower in group K₁ and group K₂ than group P(p<0.05, P < 0.01) . (2) There were no significant differences in the target concentration of propofol between group K₁ and group P and it was lower in group K2 than in group P ( P < 0.05 ) after operation 90 min,at closing peritonaeum, at operation finished and after extubation. (3) There were no significant differences in the time of emergence from anesthesia and extubation among three groups. None of the patients reported awareness, delirium, nightmares and hallucinations.Conclusion The dosage of fentanyl and propofol can be lower low dose when ketamine given intravenously during total intraveneous anesthesia of propofol. Spiritual adverse effects of low dose ketamine is counteracted by propofol. Low dose ketamine does not influence time of emergence from anesthesia and extubation .