Comparison of the hemodynamic effects of propofol and ketamine as anesthetic induction agents during high-dose remifentanil administration: a single-center retrospective comparative study.
10.17245/jdapm.2015.15.3.129
- Author:
Takuro SANUKI
1
;
Gaku MISHIMA
;
Shinji KURATA
;
Toshihiro WATANABE
;
Kensuke KIRIISHI
;
Mizuki TACHI
;
Yu OZAKI
;
Ichiro OKAYASU
;
Mari KAWAI
;
Yuki MATSUSHITA
;
Keiichiro MIURA
;
Takao AYUSE
Author Information
1. Division of Clinical Physiology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. sanuki@nagasaki-u.ac.jp
- Publication Type:Comparative Study ; Original Article
- Keywords:
Hemodynamic changes;
High-dose remifentanil anesthesia;
Ketamine;
Propofol
- MeSH:
Anesthesia;
Arterial Pressure;
Depression;
Heart Rate;
Hemodynamics*;
Humans;
Ketamine*;
Propofol*;
Retrospective Studies*;
Surgery, Oral
- From:Journal of Dental Anesthesia and Pain Medicine
2015;15(3):129-134
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We hypothesized that ketamine, when administered as the anesthetic induction agent, may prevent cardiovascular depression during high-dose remifentanil administration, unlike propofol. To test our hypothesis, we retrospectively compared the hemodynamic effects of ketamine, during high-dose remifentanil administration, with those of propofol. METHODS: Thirty-eight patients who underwent oral surgery at the Nagasaki University Hospital between April 2014 and June 2015 were included in this study. Anesthesia was induced by the following procedure: First, high-dose remifentanil (0.3-0.5 µg/kg/min) was administered 2-3 min before anesthesia induction; next, the anesthetic induction agent, either propofol (Group P) or ketamine (Group K), was administered. Mean arterial pressure (MAP) and the heart rate were recorded by the automated anesthesia recording system at four time points: immediately before the administration of high-dose remifentanil (T1); immediately before the administration of propofol or ketamine (T2); 2.5 min (T3), and 5 min (T4) after the administration of the anesthetic induction agent. RESULTS: In Group P, the MAP at T3 (75.7 ± 15.5 mmHg, P = 0.0015) and T4 (68.3 ± 12.5 mmHg, P < 0.001) were significantly lower than those at T1 (94.0 ± 12.4 mmHg). However, the MAP values in the K group were very similar (P = 0.133) at all time points. The heart rates in both Groups P (P = 0.254) and K (P = 0.859) remained unchanged over time. CONCLUSIONS: We showed that ketamine, when administered as the anesthetic induction agent during high-dose remifentanil administration, prevents cardiovascular depression.
