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British Journal of Anaesthesia, Vol 81, Issue 5 702-706, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Haemodynamic stability and ketamine-alfentanil anaesthetic induction

R. I. Katz, A. Levy, B. Slepian, B. Sobel and R. S. Lagasse
Department of Anesthesiology, Albert Einstein College of Medicine (AECOM), Montefiore Medical Center, Bronx, NY, USA and the Northport Veterans Administration Medical Center, Northport, NY, USA, an academic affiliate of the University at Stony Brook, Stony Brook, NY, USA

We have determined if alfentanil could obtund the haemodynamic instability commonly seen at induction of anaesthesia with ketamine. Five groups of ASA I and II patients received ketamine 1 mg kg-1 i.v., preceded by saline (group 1) or alfentanil 10, 20, 30 or 40 micrograms kg-1 (groups 2-5, respectively). Heart rate (HR), mean arterial pressure (AP), postoperative patient complaints and dysphoria were noted. All groups showed increases (P < 0.05) in both HR and AP after administration of ketamine, which were progressively smaller as the dose of alfentanil increased. After tracheal intubation, all groups showed further increases in HR and AP, with groups 3-5 (alfentanil 20- 40 micrograms kg-1) showing significant obtundation (P < 0.05) of these increases compared with group 1. No patient in any group reported postoperative dysphoria or dissatisfaction with their anaesthetic. Ketamine 1 mg kg-1 with alfentanil 20-40 micrograms kg-1 provided statistically significant obtundation of the haemodynamic instability that is common with ketamine alone.
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S. R. Edwards, C. F. Minto, and L. E. Mather
Concurrent ketamine and alfentanil administration: pharmacokinetic considerations
Br. J. Anaesth., January 1, 2002; 88(1): 94 - 100.
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