• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권4호
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• pp.291-295
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• 1998

Intravenous anesthesia was compared with inhalation anesthesia in 20 patients of oral and maxillofacial surgery. The patients were randomly assigned to study in two treatment groups. 20 patients were injected ketamine and propofol. 20 patients were administered Enflurane. The respond of patients consciousness and general recovery condition of the two groups were compared. Intravenous anesthesia group were awake significantly faster without complications such as nause, vomiting, and agitation after operation than inhalation anesthesia group. Full recovery time of intravenous anesthesia group was significantly 3 times less than inhalation anesthesia group. The authors conclude that intravenous anesthesia is a practical technique for oral and maxillofacial surgery patients undergoing and may be preferable to intravenous anesthesia because of the significantly short of recovery time without complications.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권3호
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• pp.129-134
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• 2015

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 ($0.3-0.5{\mu}g/kg/min$) 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 ($75.7{\pm}15.5mmHg$, P = 0.0015) and T4 ($68.3{\pm}12.5mmHg$, P < 0.001) were significantly lower than those at T1 ($94.0{\pm}12.4mmHg$). 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.

• 한국임상수의학회지
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• 제28권2호
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• pp.211-218
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• 2011

개에서 많은 주사용 마취제가 있고 그 부작용을 줄이기 위해 다양한 약물들을 혼합하여 사용한다. 개에서 medetomidine-midazolam-ketamine (MMK) 합제에 대한 마취효과를 알아보고, 이 합제에 대한 atipamezole과 yohimbine의 길항효과를 비교하였다. 18마리 수컷 비글견을 사용하였고, 모든 개에서 medetomidine (0.04 mg/kg), midazolam (0.2 mg/kg) 및 ketamine (5 mg/kg)을 근육주사하고, 20분 후 atipamezole (0.24 mg/kg, MMKA), yohimbine (0.2 mg/kg, MMKY) 또는 생리식염수(0.1 ml/kg, MMK)를 정맥주사하였다. 유도 및 회복시간, 진정 및 진통점수, 심박수, 혈압, 직장온도, 호흡수, 동맥혈액가스를 측정하였다. 평균마취, 흉와, 기립 및 보행시간은 MMKA와 MMKY군에서 MMK군보다 유의성있게 짧았다. 그러나 MMKA군과 MMKY군 간의 유의적인 차이는 없었다. 모든 군에서 MMK 투여는 개에서 만족스런 진정 및 진통을 일으켰다. 그러나 atipamezole이나 yohimbine 투여 후 자세점수 및 유해자극반응은 MMK군에 비해 MMKA나 MMKY군에서 유의성있게 감소하였다. 본 실험 결과 MMK는 양호한 진정 및 마취효과를 나타냈고, atipamezole과 yohimbine은 개에서 MMK 마취를 길항하는 데 안전하고 효과적으로 사용될 수 있을 것으로 사료된다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권3호
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• pp.151-158
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• 2019

Background: This study aimed to examine whether the combination of low-dose ketamine and propofol in deep sedation is clinically useful in controlling the behavior in intellectually disabled patients who are typically extremely noncooperative during dental procedures. Methods: A total of 107 extremely noncooperative intellectually disabled adult patients were analyzed. In all patients, deep sedation was performed using either propofol alone (group P) or using a combination of propofol and 0.2 mg/kg or 0.4 mg/kg ketamine (groups PK0.2 and PK0.4, respectively). The procedures were performed in the order of insertion of nasal cannula into the nostril, attachment of mouth gag, and mouth cleaning and scaling. The frequency of patient movement during the procedures, mean arterial pressure, heart rate, peripheral oxygen saturation, recovery time, discharge time, and postoperative nausea and vomiting were examined. Results: The three groups were significantly different only in the frequency of patient movement upon stimulation during single intravenous injection of propofol and scaling. Conclusion: For propofol deep sedation, in contrast to intravenous injection of propofol alone, prior intravenous injection of low-dose ketamine (0.4 mg/kg) is clinically useful because it neither affects recovery, nor causes side effects and can suppress patient movement and vascular pain during procedures.

• 대한간호학회지
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• 제36권1호
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• pp.114-126
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• 2006

Purpose: This study was performed to evaluate the pre-emptive analgesic effects of a small dose of intravenous ketamine on postoperative pain in patients undergoing a hysterectomy. Method: Sixty patients undergoing a hystrectomy under general anesthesia were randomly allocated to 2 groups. The experimental group(30 patients) received 0.3mg/kg of ketamine after induction of anesthesia, approximately 5 min prior to surgery, but the control group(30 patients)did not receive ketamine. Data was collected in a double-blind manner from April 1st, to October 30th, 2004. Postoperatively, the patients used a patient-controlled analgesia(PCA) pump. Blood pressure, pulse rate, pain, anxiety, count of times pressing the PCA button, administeration of additional analgesics and side effects of ketamine were measured at 1 hour, 3 hours, 6 hours and 24 hours after the operation. Result: There were no statistical differences in blood pressure, pulse rate, pain and anxiety between the experimental and control groups. There were statistical differences in blood pressure, pulse rate, pain and anxiety during the 24 hours postoperatively. In the experimental group, the number of times pressing the PCA button and administering additional analgesic drugs were significantly lower than those of the control group. Conclusion: A 0.3 mg/kg dose of ketamine given at approximately 5 min before surgery resulted in decreasing the number of times pressing the PCA and the administration of additional analgesics.

• 한국임상수의학회지
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• 제8권2호
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• pp.171-175
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• 1991

This study was carried out to evaluate the effects of doxapram after ketamine treatment. Twelve healthy dogs were anesthetized with ketamine(15mg/kg IM) and then twenty minutes after the injection of ketamine six dogs received doxapram(2mg/kg IV)and six dogs received saline(5$m\ell$ IV)as a control group. Recovery time, respiratory rate, heart rate and electrocardiogram findings(ECG)were recorded. Recovery time was significantly decreased(p<0.05)by doxapram. Respiratory rate showed a maximal increase immediately after the administration of doxapram. Thereafter respiratory rate gradually decreased and revealed normal levels 10 minutes after the injection of doxapram. Ketamine increased significantly (p<0.05) heart rate. Heart rate showed slight increase immediately after the administration of doxapram. Thereafter heart rate gradually decreased, and revealed normal levels 20 minutes after the injection of doxapram.

• 한국임상수의학회지
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• 제29권1호
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• pp.12-17
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• 2012

많은 약물들이 개의 진정 및 마취를 위해 근육내 투여를 통해 사용되고 있다. 개 마취를 위한 많은 근육내 병용투여 방법이 정립되었으나 xylazine-diazepam-ketamine 병용투여에 대한 연구는 미흡하다. 따라서 본 연구의 목적은 개에서 xylazine-diazepam-ketamine 병용투여의 영향을 연구하는 것이다. 12 마리의 혼혈 종 개를 사용하였으며 diazepam (0.5 mg/kg), xylazine (1.1 mg/kg)에 두 가지 용량의 ketamine (5 mg/kg; group 1, 10 mg/kg; group 2)을 근육내로 투여하여 비교하였다. 마취 시간은 group 2에서 group 1과 비교 시 유의적으로 길었으며 혈압은 약물 투여 후 두 군에서 모두 유의적으로 증가 하였다. $S_aO_2$ 수준도 약물 투여 후 두 군에서 모두 유의적으로 감소 하였다. 마취는 두 군에서 모두 적절히 이루어졌다. 본 실험 결과 diazepam (0.5 mg/kg), xylazine (1.1 mg/kg)에 두 가지 용량의 ketamine (5 mg/kg, 10 mg/kg)의 병용투여는 개에서 짧은 시간의 깊은 진정 및 마취 시에 사용할 수 있는 효과적인 방법으로 생각된다.

• Archives of Plastic Surgery
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• 제50권1호
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• pp.30-36
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• 2023

Background Most children with facial lacerations require sedation for primary sutures. However, sedation guidelines for invasive treatment are lacking. This study evaluated the current status of the sedation methods used for pediatric facial laceration repair in Korea. Methods We surveyed one resident in each included plastic surgery training hospital using face-to-face interviews or e-mail correspondence. The health care center types (secondary or tertiary hospitals), sedation drug types, usage, and dosage, procedure sequence, monitoring methods, drug effects, adverse events, and operator and guardian satisfaction were investigated. Results We included 45/67 hospitals (67%) that used a single drug, ketamine in 31 hospitals and chloral hydrate in 14 hospitals. All health care center used similar sedatives. The most used drug administered was 5 mg/kg intramuscular ketamine (10 hospitals; 32%). The most common chloral hydrate administration approach was oral 50 mg/kg (seven hospitals; 50%). Twenty-two hospitals (71%) using ketamine followed this sequence: administration of sedatives, local anesthesia, primary repair, and imaging work-up. The most common sequence used for chloral hydrate (eight hospitals; 57%) was local anesthesia, administration of sedatives, imaging work-up, and primary repair. All hospitals that used ketamine and seven (50%) of those using chloral hydrate monitored oxygen saturation. Median operator satisfaction differed significantly between ketamine and chloral hydrate (4.0 [interquartile range, 4.0-4.0] vs. 3.0 [interquartile range, 3.0-4.0]; p <0.001). Conclusion The hospitals used various procedural sedation methods for children with facial lacerations. Guidelines that consider the patient's condition and drug characteristics are needed for safe and effective sedation.

• 대한치과마취과학회지
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• 제12권2호
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• pp.111-114
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• 2012

Attention deficit hyperactivity disorder (ADHD) is characterized by inattention, impulsivity, and hyperactivity. Given high incidence of ADHD, many children with ADHD is likely to present for anesthesia. This case report suggests intramuscular premedication as an alternative method for anesthetic induction. A 9-year-old male patient with ADHD was transferred for dental treatment under general anesthesia. The patient refused to go into dental clinic office. Oral midazolam was given to the patient, however, he was resistant to take midazolam via oral route. Instead, we administer midazolam and ketamine via intramuscular route. After less than 10 miniutes, the patient became drowsy and was transferred to dental chair. Intravenous access and mask inhalation was possible. The patient received dental treatment under general anesthesia and recovered in a non-complicated way. In this case, intramuscular sedation with midazolam and ketamine was used as a premedication in highly uncoopearive patient refused to take oral sedative medication.

• 한국임상수의학회지
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• 제28권5호
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• pp.479-485
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• 2011

비글견에서 remifentanil/ketamine 점적 투여 병용마취법과 remifentanil/propofol 점적 투여 병용마취법이 심폐기능에 미치는 영향에 대하여 비교평가하였다. 14 마리의 비글견을 이용하였다. 실험견은 acepromazine (0.1 mg/kg, 피하)과 medetomidine (20 ${\mu}g$/kg, 정맥내)으로 전처치하고, Group P는 정맥 내 propofol 1 mg/kg, Group K는 정맥 내 ketamine 5 mg/kg으로 마취 유도 하고, 이 후 실험군별로 고정된 용량의 remifentanil (0.5 ${\mu}g$/kg/min)과 ketamine 0.1 mg/kg/min 또는 propofol 0.3 mg/kg/min을 3 시간 동안 투여하였다 (Group K와 Group P). 동맥혈압, 심박수, 호흡 수, 혈액가스분석과 마취회복기 동안의 행동변화를 측정하였다. 또한 toe-web clamping 검사를 통해 마취 깊이를 평가하였다. 외과적 마취기는 두 군 모두에서 전 시간 동안 유지가 되었다. Group K의 수축기 동맥혈압, 평균 동맥혈압, 동맥산소 분압, 동맥 산소 포화도는 Group P에 비해 정상 범위 내에서 현저히 높았으며 Group K의 이산화탄소 분압은 Group P에 비해 현저히 낮았다. 그러나 이완기 동맥혈압, 심박수, 호흡수에서는 현저한 차이가 없었다. 점적투여 중단시점부터 발관까지의 평균시간은 Group K에서 현저히 감소되었지만, 평균 sitting time은 Group P에서 현저히 감소되었다. 평균 head-up time과 평균 walking time은 현저한 차이가 없었다. Group K에서는 약간의 근강직, 머리 흔듬, 혀로 핥는 동작이 회복기에 관찰되었다. 결론적으로, Group K가 Group P보다 심폐 기능에서 더 좋았다. 즉, remifentanil/ketamine을 이용한 점적투여 병용마취법이 remifentanil/propofol을 이용한 점적투여 병용마취법 보다 3 시간의 마취 유지에서 보다 나은 방법으로 판단되었다.