Korean J Anesthesiol.  1998 Jun;34(6):1136-1143. 10.4097/kjae.1998.34.6.1136.

Comparison of Midazolam-Ketamine with Midazolam for Sedation during Retrobulbar Block in Cataract Surgery

• Park JW
• Kim JS
• Han CS
• Kim IH
• Kim YJ
• Kim CS
• Ahn KR

• KMID: 2091222
• DOI: http://doi.org/10.4097/kjae.1998.34.6.1136

Abstract

BACKGROUND: Many ophthalmic procedures can be performed using a retrobulbar regional anesthetic technique. However, retrobulbar block is painful and most of patients express anxiety about the procedure. In addition, several life-threatening complications may occur. We compared the effects of midazolam and midazolam-ketamine as a sedative during retrobulbar block in cataract surgery.
METHODS
Thirty patients undergoing cataract surgery were randomly allocated into two groups, group I (n=15) was received midazolam and group II (n=15), midazolam-ketamine. Mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO2) were compared before administration of drugs and 1, 2, 3, 4, 5, 10, 20, and 30 min after administration of drugs. Patients' movement requiring restraint were also checked. In the recovery room, postoperative nausea and vomiting, recall, delirium and/or hallucinations, and ocular complications were recorded.
RESULTS
There were no significant differences in MAP and SpO2 between groups but heart rates were significantly increased at 1, 2, 3, 4, and 5 min than baseline in group II. Movement score was significantly lower in Group II than in Group I during the block (p<0.05). Recall during performance of the nerve block occured more often in Group I than in Group II (p<0.05).
CONCLUSION
Low-dose midazolam-ketamine sedation sequence was superior to a midazolam technique regarding patients' movement and recall.

Keyword

Anesthetics, intravenous: ketamine; midazolam; Anesthetic Techniques: retrobulbar block; Hypnosis: sedation

MeSH Terms

Anxiety
Arterial Pressure
Cataract*
Delirium
Hallucinations
Heart Rate
Humans
Midazolam*
Nerve Block
Oxygen
Postoperative Nausea and Vomiting
Recovery Room
Midazolam
Oxygen