CLINICAL STUDIES OF INDUCTION AGENTS XXXVIII: EFFECT OF PREMEDICANTS AND SUPPLEMENTS ON KETAMINE ANAESTHESIA

Abstract

Because of the high incidence of complications occurring with atropine premedication the effects of sixteen combinations of premedicant drugs on ketamine anaesthesia have been studied during minor and major surgical procedures. Tranquillizer and hypnotic drugs and droperidol-containing mixtures were the least effective, both in reducing the hypertensive response produced by ketamine and in diminishing emergence sequelae. Particularly disappointing was the effect of a high (30 mg) dose of diazepam on emergence upsets. Opiate and opiate-hyoscine combinations were the most effective in minimizing both hypertension and emergence sequelae. Opiate-hyoscine mixtures were particularly effective in making ketamine anaesthesia acceptable to patients for minor surgery. The use of ketamine for induction of general anaesthesia for major lower abdominal surgery was followed by a lower incidence of emergence sequelae in each of the three premedicant groups studied than in the corresponding minor surgery series. Again, both opiate-hyoscine and droperidol-fentanyl premedication produced a very high patient acceptability for this anaesthetic technique. However, as a routine induction agent ketamine causes more problems than thiopentone, methohexitone or propanidid.