Abstract
Fifty patients undergoing endoscopy (laryngoscopy, bronchoscopy, mediastinoscopy) were anaesthetised in a double-blind prospective trial using total intravenous anaesthesia. Half of the patients were anaesthetised with an infusion of a solution of 250 mg ketamine and 12.5 mg midazolam. The other patients received an infusion of a solution of 250 mg ketamine and 20 mg diazepam. In addition, both groups were given increments of 50-100 μg of fentanyl. The immediate awakening time (t1) was not significantly different between groups, but the patients who had received midazolam-ketamine, had a significantly shorter time to more complete recovery (t2), a significantly lower frequency of emergence reactions and were more satisfied with the anaesthetic than the patients who had received diazepamketamine. There was no difference between groups with respect to intraoperative heart rate and blood pressure. No awareness during anaesthesia was reported.
Résumé
Une étude prospective à double insu a été faite chez cinquante patients anesthésiés par voie veineuse seulement, pour endoscopie (laryngoscopie, bronchoscopie, médiastinoscopie). La moitié des patients ont été anesthésiés avec une solution de 250 ml de kétamine et de 12.5 mg de midazolam par infusion. Ľautre moitié a reçu une solution de 250 mg de kétamine et de 20 mg de diazépam par infusion. De plus, les deux groupes ont reçu des doses croissantes de 50-100 μg de fentanyl. Le temps de réveil immédiat (t2) n’était pas significativement plus court chez les patients ayant reçu du midazolam-kékétamine, mais, chez ces patients, le temps de rétablissement plus complet était significativement plus court (t2) la fréquence des réactions à ľémergence était significativement plus basse et ces patients étaient plus satisfaits de ľanesthésie que les patients qui avaient reçu du diazépam-kékétamine. Il n’y pas eu de différence entre les groupes en ce qui a trait à la fréquence cardiaque et à la tension artérielle intraopératoire. On a rapporté aucune reprise de conscience durant ľanethésie.
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Sjaellandsgade 112, 8000 Aarhus C, Denmark.
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Toft, P., Romer, U. Comparison of midazolam and diazepam to supplement total intravenous anaesthesia with ketamine for endoscopy. Can J Anaesth 34, 466–469 (1987). https://doi.org/10.1007/BF03014351
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DOI: https://doi.org/10.1007/BF03014351