Untoward effects of ketamine combined with diazepam for supplementing conduction anaesthesia in young and middle-aged adults.

Abstract

Fifty-six young and 29 middle-aged adults who were scheduled for lower abdominal, anorectal or extremity surgery under epidural, sacral or brachial plexus blockades received intravenous analgesic or anaesthetic doses of ketamine, combined with diazepam, immediately before the start of the operation. Forty-one patients received no supplementary drugs for the conduction anaesthesia and were divided into two groups of controls. On the day following the operation, all the patients were asked about their postanaesthetic reactions and their acceptance of the anaesthetic technique, and the nursing staff expressed their opinion on the amount of work and supervision needed during the post-operative care of the patients. Administration of ketamine 0.5 mg/kg with diazepam 0.15 mg/kg to young or middle-aged patients was not associated with more side-effects or a greater need for post-operative care and supervision than in the control groups. Administration of anaesthetic doses of ketamine 1.5 mg/kg and 3.0 mg/kg with 0.15 mg/kg and 0.3 mg/kg of diazepam, respectively, caused significantly (P less than 0.05) more post-operative anxiety and confusion, as well as a significantly greater need for post-operative care and supervision than in the control patients. It is concluded that, in young or middle-aged patients, supplementing conduction anaesthesia with ketamine 0.5 mg/kg plus diazepam 0.15 mg/kg is not associated with the untoward effects which can be expected after anaesthetic doses of 1.5 mg/kg (or more) of ketamine.