Korean J Anesthesiol.  2006 Apr;50(4):434-438. 10.4097/kjae.2006.50.4.434.

The Effect of Combined Fentanyl and Ketamine Administration in the Monitored Anesthetic Care of Ambulatory Strabismus Surgery

• Lee Y
• Chang HW
• Shim JY

• KMID: 1936711
• DOI: http://doi.org/10.4097/kjae.2006.50.4.434

Abstract

BACKGROUND: Monitored anesthetic care can provide patient safety and optimal surgical conditions. However, propofol and fentanyl decrease the hypoxic ventilatory response and heart rate. Ketamine has less respiratory depression and blocks bradycardia. Furthermore, ketamine can reduce the amount of opioid use but it delays discharge in the outpatient anesthesia. Therefore, this study retrospectively examined the effects of combined fentanyl and ketamine administered during monitored anesthetic care on the use of opioids, cardiorespiratory side effects, and patient discharge.
METHODS
The anesthetic room, the recovery room and day surgery center records of ambulatory strabismus surgery with monitored anesthetic care was reviewed by anesthesiologists from Oct. 2004 to July 2005. The patients were classified as those receiving either fentanyl (F group: n = 32) or fentanyl and ketamine (FK group: n = 19) with a propofol infusion. The fentanyl dose used, the need for airway support, anticholinergics and naloxone were compared. The stay in the recovery room and the day surgery center was also examined.
RESULTS
The FK group used significantly less fentanyl than the F group (P < 0.05). Although airway support was needed, there was less anticholinergics and naloxone used in the FK group, but this difference was not significant. The stay in recovery room and the day surgery center were similar.
CONCLUSIONS
Co-administered ketamine reduces the amount of fentanyl-needed, but it does not reduce the need for airway support and anticholinergics. In addition, co-administered ketamine does not affect the number of days in the recovery room and day surgery center.

Keyword

ambulatory surgery; fentanyl; ketamine; monitored anesthetic care; strabismus

MeSH Terms

Ambulatory Surgical Procedures
Analgesics, Opioid
Anesthesia
Bradycardia
Cholinergic Antagonists
Fentanyl*
Heart Rate
Humans
Ketamine*
Naloxone
Outpatients
Patient Discharge
Patient Safety
Propofol
Recovery Room
Respiratory Insufficiency
Retrospective Studies
Strabismus*
Analgesics, Opioid
Cholinergic Antagonists
Fentanyl
Ketamine
Naloxone
Propofol