Effects of Diazepam-Ketamine-N2O-O2 Anesthesia on the Cardiovascular System and Psychotomimetic Reaction

Park, Jong Kwan; Jin, Young Ho; Lim, Suk Hwan; Song, He Sun

Abstract

The authors observed the anesthetic effects of an intravenous drip of ketamine hydrochloride supplemented with diazepam and nitrous oxide on the cardiovascular system and the psychotomimetic reaction in 38 relarively healthy patients who underwent abdominal surgery at Chonbuk National Hospital from May to Sept., 1985. The results were compared with those obtained from patients anesthetized with halothanenitrous oxide-oxygen. 1) The rate of intravenous drip of ketamine was 1mg/kg/hr, which adequately maintained the level of surgical anesthesia. The total amount of pancuronium required for satisfactory skeletal muscle relaxation was 40% more in the ketamine group than in the halothane group. 2) Following ketamine anesthesia, systolic pressure revealed a transient increase immediately after induction, and about 4minutes after the commencement of surgery it thereafter returned to the preinduction level and remained stable during the operation this is in contrast with halothane anesthesia in which the systolic pressure decreased and remained below the level of preinduction after a transient increase immediately after induction. 3) The difference in diastolic pressure between ketamine and halothane anesthesia was significant(p<0.05) as the pressure increased and remained at a high level in the ketamine group while it decreased to the preinduction level following a treansient increase after induction in the halothane group. 4) pulse rate exhibited a greater increase in the ketamine group than in the halothane group after induction, but there was no statistical significance between the two groups(p>0.05). 5) Contrary to halothane anesthesia, anticholinergic premedication could not completely prevent endotracheal secretion following ketamine anesthesia. 6) Premedication with diazepam could not completely relieve psychotomimetic reactions including convulsion and hallucination after ketamine anesthesia.