Journal of Anesthesia

, Volume 24, Issue 1, pp 31–37

Ketamine eliminates propofol pain but does not affect hemodynamics during induction with double-lumen tubes

Authors

  • Masato Iwata
    • Department of AnesthesiologyNara Medical University
    • Department of AnesthesiologyNara Medical University
  • Masahiko Kawaguchi
    • Department of AnesthesiologyNara Medical University
  • Toshitaka Kimura
    • Departments of Thoracic and cardiovascular SurgeryNara Medical University
  • Takashi Tojo
    • Departments of Thoracic and cardiovascular SurgeryNara Medical University
  • Shigeki Taniguchi
    • Departments of Thoracic and cardiovascular SurgeryNara Medical University
  • Hitoshi Furuya
    • Department of AnesthesiologyNara Medical University
Original Article

DOI: 10.1007/s00540-009-0833-5

Cite this article as:
Iwata, M., Inoue, S., Kawaguchi, M. et al. J Anesth (2010) 24: 31. doi:10.1007/s00540-009-0833-5

Abstract

Background and objective

Propofol injection during induction of anesthesia induces pain. Ketamine has been shown to reduce the injection pain. However, ketamine has unfavorable adverse effects, including increased secretion production and hemodynamic responses, which might induce pulmonary or hemodynamic adverse events, especially in patients undergoing lung surgery who require a double-lumen tube (DLT). The aim of this study was to determine whether ketamine can safely reduce propofol injection pain during induction of anesthesia for lung surgery.

Methods

Forty-five patients scheduled for elective lung surgery requiring DLT were randomly allocated into three groups. Patients received saline (control), ketamine 0.5 mg kg−1 (0.5 ketamine), or ketamine 1.0 mg kg−1 (1.0 ketamine), followed by 5 ml propofol 30 s later. An anesthesiologist blinded to the study group assessed pain score during induction, hemodynamics during DLT placement, and secretion production during anesthetic management.

Results

Pretreatment of 0.5 mg kg−1 ketamine reduced the incidence and intensity of propofol injection pain, whereas 1.0 mg kg−1 ketamine completely eliminated the pain. There were no significant differences regarding oxygenation during one-lung ventilation (OLV) and hemodynamics during induction among the three groups, although ketamine increased secretion production.

Conclusions

One milligram per kilogram of ketamine completely eliminated pain associated with propofol injection without affecting hemodynamics during induction of anesthesia and oxygenation during OLV.

Keywords

KetaminePropofol painDouble-lumen tube

Copyright information

© Japanese Society of Anesthesiologists 2009