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KMID : 0381219920240020181
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Journal of RIMSK
1992 Volume.24 No. 2 p.181 ~ p.191
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Total Intravenous Anesthesia with Ketamine and Fentanyl
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Abstract
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Total intravenous anesthesia(TIVA0 with ketamine and fentanyl has many advantages such as no air pollution, no hepatic or renal toxicity, good postoperative pain relief and low anesthetic cost compared with inhalation anesthesia, while this
anesthetic
method has several disadvantage such as hypertension, delayed recovery and emergence delirium. The authors tried this new TIVA method with ketamine and fentanyl to the 50 patients in ASA class I or II during 5 months from June to October 1991.
@ES The results were as follows:
@EN 1) Systolic blood pressure, diastolic blood pressure and mean arterial pressure increased and pulse rate decreased intraoperatively(p<0.05).
RPP(rate-pressure product) also increased after anesthetic induction(p>0.05), but thereafter there was no change in RPPP.
2) The components of ABGA such as pH, PaCO2, PaO2, HCO2, BE and SaO2 were within normal limits postoperative 30, 60, 90, 120 minutes and 8, 12 hours.
3) The blood sugar level increased continuously during operation(p<0.05), but it became normal from postoperative 50 minutes.
4) There were some complications such as movement, eye opening and grimace during anesthesia, and there were another complications such as dream, nausea and vomiting, dizziness and urinary retention postanesthetic 2 hours and 24 hours.
5) According to the results of hepatic or renal function test of postoperative 3 rd day the levels of alkaline phosphattse and BUN decreased significantly(p<0.05), but there were no significant changes in the levels opf SGOT, SGPT and
creatinine.
6) Therefore it is supposed to be very necessary to substitute other new nonbarbiturate anesthetics such as propofol for ketamie to make up for the disadvantages of TIVA with ketamine and fentanyl.
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KEYWORD
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