Pretreatment with small-dose ketamine reduces predicted effect-site concentration of propofol required for loss of consciousness and Laryngeal Mask Airway insertion in women

Okuyama, Kazuhiko; Inomata, Shinichi; Okubo, Naomitsu; Watanabe, Iwao

doi:10.1016/j.jclinane.2010.08.004

Cited by 15 publications

(13 citation statements)

References 37 publications

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“…Clinical effects of propofol and ketamine seem to be complementary. When propofol and ketamine are administered in combination, doses of both agents decrease and unwanted effects are minimized 25 . It was shown in studies of adult and pediatric patients that ketamine applied before propofol induction for LMA insertion preserved hemodynamic stability 24,26,27 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Propofol and Ketamine-Propofol Mixture (Ketofol) on Laryngeal Tube-Suction II Conditions and Hemodynamics: A Randomized, Prospective, Double-Blind Trial

Özgül

Begeç

Karahan

et al. 2013

Current Therapeutic Research

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ObjectiveThe aim of our study is to compare the effect of ketamine–propofol mixture (ketofol) and propofol on the laryngeal tube-Suction II (LTS II) insertion conditions and hemodynamics.MethodsEighty American Society of Anesthesiologists class 1 and 2 patients were divided into 2 random groups to receive either 1 µg/kg remifentanil and propofol 2 mg/kg in Group P (n = 40), or 1 µg/kg remifentanil and ketofol (using a 1:1 single syringe mixture of 5 mg/mL ketamine and 5 mg/mL propofol) in Group K (n = 40) before induction of anesthesia. After induction, LTS II was inserted. Heart rate and noninvasive blood pressure were recorded before induction of anesthesia (t0); immediately following induction (t1); immediately after LTS II insertion (t2); and 3 minutes (t3), 5 minutes (t4), and 10 (t5) minutes after LTS II insertion. Conditions of insertion of LTS II were assessed and scored 1 to 3 using 6 variables as follows: mouth opening, swallowing, coughing, head and body movements, laryngospasm, and ease of LTS II insertion by the same experienced anesthesiologist who did not know the agents. LTS II insertion summed score was prepared depending upon these variables.ResultsIn regard to LTS II insertion summed score, Group K was more favorable than Group P (P < 0.05). Apnea duration was longer in Group P (385.0 seconds [range = 195.0–840.0 seconds]) compared with Group K (325.50 seconds [range = 60.0–840.0 seconds]) but this was not statically significant. The heart rate values were significantly lower at all measurement intervals in both groups compared with the baseline values (P < 0.05). There was no difference in heart rate between Group P and Group K. The mean arterial pressure values were significantly lower at all measurement intervals in Group P compared with baseline values (P < 0.05). In Group K, the mean arterial pressure values were significantly lower at all measurement intervals compared with the baseline values, except t2 (P < 0.05). There was a significant difference between Group P and Group K in terms of mean arterial pressure at t3 (P < 0.05).ConclusionsWe found that ketofol provided better insertion summed score for LTS II than propofol, with minimal hemodynamic changes.

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Section: Discussionmentioning

confidence: 99%

Comparison of Propofol and Ketamine-Propofol Mixture (Ketofol) on Laryngeal Tube-Suction II Conditions and Hemodynamics: A Randomized, Prospective, Double-Blind Trial

Özgül

Begeç

Karahan

et al. 2013

Current Therapeutic Research

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“…In our study, the SBP and HR were higher in the group KP, however, SBP and HR reached statistically significant levels only at t 1 and t 4 . Some studies have demonstrated that the co-administration of propofol and ketamine is more favourable due to the stabilisation of the hemodynamics, given that the BP and HR effects of the individual agents tend to cancel one another out (30). Ephedrine has both α and β adrenergic properties and is helpful in the treatment of hypotension, but it can cause tachycardia and arrhythmia (31).…”

Section: Discussionmentioning

confidence: 99%

Effects of Ketamine-Propofol Mixture on Intraocular Pressure and Hemodynamic in Elderly Patients: A Randomized Double-Blind Trial

Aydoğan¹,

Demirel²,

Erdoğan³

et al. 2014

Turk J Anesth Reanim

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“…The data of the first clinical example are extracted from Okuyama et al . In a double‐blinded study on the effect of ketamine on propofol injection pain, 50 patients were randomly allocated to a ketamine group and a control group.…”

Section: Examplesmentioning

confidence: 99%

“…Four ordinal categories, summarized from the World Health Organization standardized protocol, were used in the study, namely, adequate clinical and parasitological response, late parasitological failure, late clinical failure, and early treatment failure. In another example, Okuyama et al conducted a clinical study to investigate the effect of small‐dose ketamine on propofol injection pain. The level of pain was measured on a four‐point ordinal scale of none, mild, moderate, and severe.…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, it would be difficult to use the LLS model to describe two treatments with very different skewness that is not uncommon for the ordinal data collected in clinical studies. For instance, in the clinical study of the effect of small‐dose ketamine on propofol injection pain by Okuyama et al , the pain level dropped significantly for the ketamine treatment group. Consequently, the numbers of patients falling into the four categories (none, mild, moderate, and severe) were 17, 2, 3, and 3, which are highly skewed for the ketamine treatment group.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of two treatments with skewed ordinal responses

Lü

Poon

Cheung

2015

Statistics in Medicine

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In clinical studies, the proportional odds model is widely used to compare treatment efficacies when the responses are categorically ordered. However, this model has been shown to be inappropriate when the proportional odds assumption is invalid, mainly because it is unable to control the type I error rate in such circumstances. To remedy this problem, the latent normal model was recently promoted and has been demonstrated to be superior to the proportional odds model. However, the application of the latent normal model is limited to compare treatments with similar underlying distributions except possibly their means and variances. When the underlying distributions are very different in skewness, both of the aforementioned procedures suffer from the undesirable inflation of the type I error rate. To solve the problem for clinical studies with ordinal responses, we provide a viable solution that relies on the use of the latent Weibull distribution, which is a member of the log-location-scale family. The proposed model is able to control the type I error rate regardless of the degree of skewness of the treatment responses. In addition, the power of the test also outperforms that of the latent normal model. The testing procedure draws on newly developed theoretical results related to latent distributions from the location-scale family. The testing procedure is illustrated with two clinical examples.

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Pretreatment with small-dose ketamine reduces predicted effect-site concentration of propofol required for loss of consciousness and Laryngeal Mask Airway insertion in women

Cited by 15 publications

References 37 publications

Comparison of Propofol and Ketamine-Propofol Mixture (Ketofol) on Laryngeal Tube-Suction II Conditions and Hemodynamics: A Randomized, Prospective, Double-Blind Trial

Comparison of Propofol and Ketamine-Propofol Mixture (Ketofol) on Laryngeal Tube-Suction II Conditions and Hemodynamics: A Randomized, Prospective, Double-Blind Trial

Effects of Ketamine-Propofol Mixture on Intraocular Pressure and Hemodynamic in Elderly Patients: A Randomized Double-Blind Trial

Comparison of two treatments with skewed ordinal responses

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