title: Haemodynamic stability and ketamine-alfentanil anaesthetic induction.
abstract: We have determined if alfentanil could obtund the haemodynamic instability commonly seen at induction of anaesthesia with ketamine. Five groups of ASA I and II patients received ketamine 1 mg kg-1 i.v., preceded by saline (group 1) or alfentanil 10, 20, 30 or 40 micrograms kg-1 (groups 2-5, respectively). Heart rate (HR), mean arterial pressure (AP), postoperative patient complaints and dysphoria were noted. All groups showed increases (P < 0.05) in both HR and AP after administration of ketamine, which were progressively smaller as the dose of alfentanil increased. After tracheal intubation, all groups showed further increases in HR and AP, with groups 3-5 (alfentanil 20-40 micrograms kg-1) showing significant obtundation (P < 0.05) of these increases compared with group 1. No patient in any group reported postoperative dysphoria or dissatisfaction with their anaesthetic. Ketamine 1 mg kg-1 with alfentanil 20-40 micrograms kg-1 provided statistically significant obtundation of the haemodynamic instability that is common with ketamine alone.
authors.affiliation: Department of Anesthesiology, Albert Einstein College of Medicine (AECOM), Montefiore Medical Center, Bronx, NY, USA.
authors.forename: R I
authors.initials: RI
authors.lastname: Katz
authors.forename: A
authors.initials: A
authors.lastname: Levy
authors.forename: B
authors.initials: B
authors.lastname: Slepian
authors.forename: B
authors.initials: B
authors.lastname: Sobel
authors.forename: R S
authors.initials: RS
authors.lastname: Lagasse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015760:Alfentanil / Q000494:pharmacology*; D019162:Anesthetics, Combined / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007649:Ketamine / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D013268:Stimulation, Chemical
chemical_list: D019162:Anesthetics, Combined; D015760:Alfentanil; D007649:Ketamine