Decreased intraoral secretions during sedation-analgesia with propofol-ketamine and midazolam-ketamine combinations

Morse, Zac; Sano, Kiyoshi; Kanri, Tomio

doi:10.1007/s005400170002

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…30 Three studies were excluded as they reported only surrogate outcomes. [31][32][33] Studies reporting the use of combination ketamine and propofol in total intravenous anesthesia were excluded, 34,35 as was one study comparing the combination to an agent not marketed in Canada. 36 Thus, eight trials were identified and included in this review ( Table 1).…”

Section: Study Selectionmentioning

confidence: 99%

Combination Ketamine and Propofol for Procedural Sedation and Analgesia

Slavík

Zed

2007

Pharmacotherapy

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The combination of ketamine and propofol for procedural sedation and analgesia theoretically may be beneficial, with the rationale being that using lower doses of each agent may result in a reduction of the undesirable adverse effects of both agents while maintaining optimal conditions for performing procedures. To examine the current evidence for the efficacy and safety of ketamine and propofol in combination for procedural sedation and analgesia, we searched the MEDLINE (1966-March 2007), EMBASE (1980-March 2007), and Cochrane Database of Systematic Reviews (through the first quarter of 2007) databases for reports describing the use of ketamine and propofol in combination for procedural sedation and analgesia. Additional published reports were identified through a manual search of references from retrieved articles. Prospective, comparative, full-text reports of studies performed in humans that were published in English were reviewed for inclusion. Both authors independently evaluated all studies. Studies in adult and pediatric patients were included if they evaluated efficacy or safety end points. Eight clinical trials were included, seven of which compared a combination of propofol and ketamine with propofol monotherapy. In these trials, variable milligram:milligram ratios of propofol and ketamine were used, ranging from 10:1-2:1, and the optimum dose of these agents in combination is unclear. Combination propofol and ketamine has not demonstrated superior clinical efficacy compared with propofol alone for procedural sedation and analgesia. Conflicting data exist regarding reduced hemodynamic and respiratory complications in patients receiving the combination compared with propofol monotherapy. At higher doses, the addition of ketamine to propofol may incur more adverse effects. Compatibility data for the two agents combined in a syringe are limited. The available evidence does not support the use of a fixed-dose ketamine-propofol combination for procedural sedation and analgesia. Further research is needed to elucidate the role, if any, of this combination for procedural sedation and analgesia.

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Section: Study Selectionmentioning

confidence: 99%

Combination Ketamine and Propofol for Procedural Sedation and Analgesia

Slavík

Zed

2007

Pharmacotherapy

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“…Since our patient had chronic urticaria, she frequently used antihistamine medication. In this case, we think that the main factor that triggers anesthesia mumps is the application of propofol (which is frequently used for sedation in the emergency room) during the operation and as she often use antihistaminic and the decrease in the secretions because of propofol, [14] the patient suffer from anesthesia mumps. Anesthesia mumps can regress in a few days with abundant hydration, symptomatic treatment or no treatment.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic mumps; A rare complication after surgery

Yurtsever

Bora

Günel

2021

Journal of Contemporary Medicine

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Anesthetic mumps is a rare complication that occurs with sudden swelling of the parotid gland, especially after surgery. Symptomatic treatment or spontaneous regression within days without sequelae. It is thought that it may be due to vasodilation, hyperemia, air leakage into the stenone duct, perioperative use of drugs such as atropine, succinylcholine, morphine, and propofol, and the posture position of the patient in the operation. Anesthetic mumps appears within the first few weeks after the operation. In this article, we presented the complication that developed in the event of a short-term procedure such as double J catheter removal.

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“…Another study showed that propofol plus ketamine reduced salivary flow versus midazolam plus ketamine. [24] Lahteenmaki et al [25] directly compared propofol with isoflurane and found marked short-term hyposalivation in both groups. Moreover, Tsai et al [26] reported that there was no significant difference in hypersalivation between TIVA (20.7%) and isoflurane anesthesia (20.9%) in soft tissue, oral, and orthopedic surgery for dogs.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of sevoflurane as an adjuvant to propofol-based total intravenous anesthesia for attenuating secretions in ocular surgery

Lai

Chang²,

Huang³

et al. 2017

Medicine

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Background:The incidence of nasal secretions into the operative field is as high as 5% in ophthalmic surgery under general anesthesia. It may induce postoperative endophthalmitis. Secretions under propofol-based total intravanous anesthesia (TIVA) are greater than sevoflurane anesthesia during surgery. Postoperative nausea and vomiting (PONV) after inhalational anesthesia is higher than TIVA and may increase intraocluar pressure. We investigated the effect of sevoflurane combination with propofol-based TIVA on nasopharyngeal secretions and PONV in ocular surgery.Methods:Fifty patients undergoing ocular operations were randomly assigned for propofol-based TIVA or propofol/sevoflurane anesthesia. In the TIVA group (n = 25), anesthesia was induced and maintained with propofol and fentanyl; in the propofol/sevoflurane group (n = 25), 1% sevoflurane anesthesia was added.Results:Nasopharyngeal excretion volume was significantly higher in the propofol-based TIVA group than in the propofol/sevoflurane group (31.0 ± 18.1 vs 13.7 ± 12.6 ml; P < .001). No significant difference in extubation time was noted (propofol-based TIVA: 6.4 ± 3.6 vs propofol/sevoflurane: 7.4 ± 3.0 minutes; P = .34). No postoperative endophthalmitis or PONV in both groups was observed.Conclusion:Sevoflurane attenuated secretions under propofol-based TIVA and did not increase the incidence of PONV or prolonged extubation in ocular surgery.

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Decreased intraoral secretions during sedation-analgesia with propofol-ketamine and midazolam-ketamine combinations

Abstract: Sedation-analgesia with PK and MK combinations controls intraoral secretions by reducing salivary flow.

Cited by 10 publications

References 13 publications

Combination Ketamine and Propofol for Procedural Sedation and Analgesia

Combination Ketamine and Propofol for Procedural Sedation and Analgesia

Anesthetic mumps; A rare complication after surgery

Efficacy of sevoflurane as an adjuvant to propofol-based total intravenous anesthesia for attenuating secretions in ocular surgery

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