title: Uneventful total intravenous anaesthesia with ketamine for schizophrenic surgical patients.
abstract: Ketamine has been considered to be contraindicated for schizophrenic patients because it may induce psychological emergence reactions and psychiatric deterioration. Total intravenous anaesthesia (TIVA) with ketamine combined with droperidol and fentanyl (DFK) has been used in 14 schizophrenic patients undergoing various surgical procedures. Two patients died post-operatively of concomitant severe disease rather than from schizophrenia related pathophysiology or anaesthetic complication. One patient showed transient mild anxiety in the early post-operative period soon relieved by the patient's routine medication. However, no patient developed exacerbations of psychosis or psychological emergence reactions during the first post-operative month. The cardiovascular state during and after DFK remained stable in all cases. It is concluded that ketamine when combined with droperidol and fentanyl is a satisfactory anaesthetic for patients with schizophrenia.
authors.affiliation: Department of Anaesthesiology, University of Hirosaki School of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ishihara
authors.forename: H
authors.initials: H
authors.lastname: Kudo
authors.forename: T
authors.initials: T
authors.lastname: Murakawa
authors.forename: A
authors.initials: A
authors.lastname: Kudo
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.forename: A
authors.initials: A
authors.lastname: Matsuki
mesh_terms: D000759:Adjuvants, Anesthesia; D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous; D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000075202:Contraindications; D004329:Droperidol; D005260:Female; D005283:Fentanyl; D006801:Humans; D007649:Ketamine; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia
chemical_list: D000759:Adjuvants, Anesthesia; D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D014150:Antipsychotic Agents; D007649:Ketamine; D004329:Droperidol; D005283:Fentanyl