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Assessment of recovery, dreaming, hemodynamics, and satisfaction in postcardiac surgery patients receiving supplementary propofol sedation with S(+)-ketamine.
MedLine Citation:
PMID:  19377413     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: S(+)-ketamine is an analgesic and sedative drug with dissociative attributes. When it is used without sedatives, nightmares have been described. The aim of this study was to assess the effects of postoperative analgosedation with propofol and S(+)-ketamine when compared to standard propofol analgosedation in terms of recovery, dreaming, hemodynamics, and patient satisfaction. METHODS: Forty-eight patients were sedated with propofol (1-3 mg/kg/h) after coronary artery bypass grafting and allocated randomly on admission to the intensive care unit to receive either S(+)ketamine (2 mg mg/kg/h; group A) or 0.9% saline as a placebo (group B) in a double-blind fashion. If necessary, boli of 3.75 mg piritramide (an opioid) were given in both groups. RESULTS: Patients receiving S(+)-ketamine had significantly higher satisfaction for pain management (Visual Analog Scale [VAS] = group A: median 10 [range 9-10]; group B: median 9 [range 6-10]) despite their lower piritramide consumption. Patients receiving S(+)ketamine showed significantly faster eye opening (82+/-51 vs 156+/-110 min) but dreamed significantly more often (at 2 h, 67% in group A vs 29% in group B; at 24 h, 43% in group A: vs 10% in group B:), whereas no significant differences were detected in the incidence of nightmares (2 h: group A: 14% vs group B: 10%; 24 h: group A: 5% vs group B: 5%). CONCLUSIONS: Patients receiving S(+)-ketamine showed higher satisfaction for pain management and dreamed more often, but they did not have more nightmares.
Authors:
Piper; Beschmann; Mengistu; Kalenka; Maleck; Boldt; Röhm
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2009-4-20
Journal Detail:
Title:  Minerva anestesiologica     Volume:  -     ISSN:  1827-1596     ISO Abbreviation:  -     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-4-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375272     Medline TA:  Minerva Anestesiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Anesthesiology and Intensive Care Medicine, Hospital of Frankenthal, Frankenthal, Germany swen.n.piper@t-online.de.
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