Intravenous anesthesia


Anesthesia and Pain Medicine. 2004 Mar. 8(1): 19-24
ⓒ Korean Society for Intravenous Anesthesia
A Comparative Study on the Frequency and Contents of Dream, Mood, Emotion and Satisfaction in the Monitored Anesthesia Care using Propofol-Fentanyl and Propofol-Ketamine
Byung Cheul Shin, M.D., Kyung Won Seo, M.D., Ji Yong Park, M.D., Hye Won Lee, M.D., Hae Ja Lim, M.D., Suk Min Yoon, M.D., and Seong Ho Chang, M.D.
Department of Anesthesiology and Pain Medicine, College of Medicine, Korea University, Seoul, Korea

Background: The monitored anesthesia care (MAC) using propofol-ketamine is useful because of hemodynamic stability, easy perioperative ventilatory care. But the possibility of psychomimetic emergence from ketamine limits it\'s usefulness. Fentanyl has the effect of good analgesia but with respiratory depression. This study was done to investigate the differences on the frequency and contents of the dream, mood, emotion, patient satisfaction between the propofol-ketamine and propofol-fentanyl in cases of the day care surgery.
Methods: Forty patients scheduled for the elective surgery for carpal tunnel syndrome were selected. They were randomly divided into fentanyl group (n = 20) and ketamine group (n = 20). A target controlled infusion (target effect concentration 2mug/ml) of propofol was done to the patients with either fentanyl 1.5mug/kg (fentanyl group) or ketamine 0.5 mg/kg (ketamine group). During the monitored anesthesia care, mean arterial pressure (MAP), oxygen saturation (SaO2), bispectal index (BIS), observer\'s assessment of alertness/sedation (OAA/S) scale were recorded. After recovery, at the postanesthetic care unit (PACU), OAA/S scale were also evaluated. On leaving the PACU, the patients were asked about the dream and its contents, emotion, mood, and satisfaction to the anesthesia.
Results: The frequency of dream was higher in the ketamine group otherwise there was no significant difference between two groups in the contents of dream, mood, emotion, and satisfaction on the anesthesia technique.
Conclusions: The monitored anesthesia care (MAC) with propofol-ketamine may be safely used as an alternative method to MAC with propofol-fentanyl.
Key words : Dream, emotion, fentanyl, ketamine, mood, propofol
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