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Ketamine-midazolam total intravenous anaesthesia for prolonged abdominal surgery

Published online by Cambridge University Press:  16 August 2006

M. M. Atallah ,
H. A. El-Mohayman  and
R. E. El-Metwally
M. M. Atallah
Affiliation:
Department of Anaesthesia, Urology & Nephrology Centre, University of Mansoura, Mansoura, Egypt
H. A. El-Mohayman
Affiliation:
Department of Anaesthesia, Urology & Nephrology Centre, University of Mansoura, Mansoura, Egypt
R. E. El-Metwally
Affiliation:
Department of Anaesthesia, Urology & Nephrology Centre, University of Mansoura, Mansoura, Egypt
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Abstract

Background and aim Infusion of ketamine and midazolam can maintain prolonged anaesthesia, but delayed recovery is a limitation. We aimed to develop an approximation regimen for the infusion of ketamine and midazolam to obtain steady-state anaesthesia with acceptable recovery.

Methods Thirty-one patients undergoing radical cystect-omy were studied. The initial regimen was calculated from drug pharmacokinetic variables and tailored in a pilot study (15 patients) to develop the approximation regimen dosage. Anaesthesia was induced with midazolam (150μgkg−1) and ketamine (2mgkg−1). Tracheal intubation and ventilation with oxygen enriched air (FiO2 = 0.35) were facilitated by muscle relaxants. Anaesthesia was maintained by the approximation regimen doses. Routine monitoring was used for all patients, but pulmonary artery catheters were inserted in 11 patients, to obtain haemo-dynamic and oxygenation variables.

Results Steady-state anaesthesia was obtained with minimal deviations in the regimen in some patients followed by reasonable recovery.

Conclusion It is concluded that infusion of ketamine and midazolam in the approximation regimen doses can be used to maintain anaesthesia for prolonged abdominal surgery.

Keywords

anaesthetic techniquesinfusionanaestheticsketaminemidazolamsurgeryabdominal
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 18 , Issue 1 , January 2001 , pp. 29 - 35
Copyright
2001 European Society of Anaesthesiology

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