Comparison of the hemodynamic effects of propofol and ketamine as anesthetic induction agents during high-dose remifentanil administration: a single-center retrospective comparative study
Sanuki Takuro, Mishima Gaku, Kurata Shinji, Watanabe Toshihiro, Kiriishi Kensuke, Tachi Mizuki, Ozaki Yu, Okayasu Ichiro, Kawai Mari, Matsushita Yuki, Miura Keiichiro, Ayuse Takao,
소속 상세정보
( Sanuki Takuro ) - Nagasaki University Graduate School of Biomedical Sciences Department of Translational Medical Sciences
( Mishima Gaku ) - Nagasaki University Graduate School of Biomedical Sciences Department of Translational Medical Sciences
( Kurata Shinji ) - Nagasaki University Hospital Department of Dental Anesthesiology
( Watanabe Toshihiro ) - Nagasaki University Hospital Department of Dental Anesthesiology
( Kiriishi Kensuke ) - Nagasaki University Hospital Department of Dental Anesthesiology
( Tachi Mizuki ) - Nagasaki University Hospital Department of Dental Anesthesiology
( Ozaki Yu ) - Nagasaki University Graduate School of Biomedical Sciences Department of Translational Medical Sciences
( Okayasu Ichiro ) - Nagasaki University Graduate School of Biomedical Sciences Department of Translational Medical Sciences
( Kawai Mari ) - Nagasaki University Graduate School of Biomedical Sciences Department of Translational Medical Sciences
( Matsushita Yuki ) - Nagasaki University Graduate School of Biomedical Sciences Department of Translational Medical Sciences
( Miura Keiichiro ) - Nagasaki University Graduate School of Biomedical Sciences Department of Translational Medical Sciences
( Ayuse Takao ) - Nagasaki University Graduate School of Biomedical Sciences Department of Translational Medical Sciences
KMID : 0980320150150030129
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.
키워드
Hemodynamic changes; High-dose remifentanil anesthesia; Ketamine; Propofol
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