Low Dose Ketamine or Fentanyl for Total Intravenous Anesthesia with Propofol for Stress Urinary Incontinence

Lee, Bong Jae

Abstract

BACKGROUND: A prospective study of 40 patients who underwent stress urinary incontinence operation was performed to study the use of ketamine as an analgesic during total intravenous anesthesia with propofol. A comparison was made with the combination in propofol with fentanyl.
METHODS
Fourty patients (ASA class 1 and 2) scheduled for stress urinary incontinence were randomly allocated into two groups, K group (propofol-ketamine, n = 20), F group (propofol-fentanyl, n = 20). Anesthesia was induced with propofol 2 mg/kg. Anesthesia was maintained with propofol 6 mg/kg/h and either ketamine 2 mg/kg/h or fentanyl 1microg/kg/h. We checked the changes of blood pressure and heart rate and O2 saturation during operation and we recorded anesthetic quality, total dose of propofol, visual analogue scale (VAS) at 30 min after operation, recovery time and postoperative side effects.
RESULTS
Arterial blood pressure and heart rate were stable in the patients of both group, except for a temporary increase of systolic blood pressure and heart rate after induction of anesthesia in K group. There were no significant differences between K group and F group in total dose of propofol, anesthesia quality, VAS at 30 min after operation, recovery time. There were higher incidence of dizziness in patients in K group, other side effects were similar.
CONCLUSIONS
We concluded that low dose ketamine with propofol can replace propofol-fentanyl for intravenous outpatients anesthesia.