Propofol With Low-Dose Ketamine for Outpatient Anesthesia

Abstract

During the latter part of the 20th century the ultra short acting barbiturates thiopental and methohexital were the “work horse” intravenous agents utilized in hospital operating rooms and oral and maxillofacial surgery offices for outpatient anesthesia. However, since its introduction in 1989 the substituted phenolic compound propofol has replaced the barbiturates in many oral surgery offices and operating rooms throughout the world. Two of propofol’s primary attributes are a short serum half-life and rapid biotransformation and elimination. These characteristics lead to the shortened recovery time which is so essential for outpatient anesthesia. However, propofol has a number of other desirable characteristics as well. It is associated with a markedly diminished incidence of laryngospasms and is well tolerated in both renal and hepatic insufficiency. In addition, propofol has anti-emetic properties, and emergence from a propofol anesthetic is associated with a profound feeling of well-being which boosts patient acceptance dramatically.