The effects of propofol with and without ketamine on human cerebral blood flow velocity and CO(2) response.
The combination of propofol and ketamine has been used for total IV anesthesia. This study was designed to clarify the effects of propofol-ketamine anesthesia on cerebral circulation by using transcranial Doppler ultrasonography. In Study 1, we examined the time course of time-mean middle cerebral artery blood flow velocity (Vmca) after ketamine (n = 10) or saline (n = 6) administration during propofol anesthesia. In Study 2, CO(2) responses were measured under the following conditions: awake (Group C, n = 7), propofol anesthesia (Group D, n = 7), and propofol-ketamine anesthesia (Group E, n = 8). Ketamine administration during propofol anesthesia administration did not affect Vmca, mean arterial pressure, or heart rate. Vmca under normocapnia in Groups D and E were 36 +/- 3 and 37 +/- 3 cm/s (mean +/- SE), respectively. The values were significantly lower than that of Group C (70 +/- 3 cm/s). The CO(2) response slopes of Groups D and E were significantly lower than that of Group C, although there was no significant difference between Groups D and E. These results suggest that ketamine does not influence Vmca or the cerebrovascular CO(2) response during propofol anesthesia administration, although the sample size in each group was small.


CONCLUSIONS
Our study suggests that ketamine does not influence middle cerebral artery blood flow velocity or the cerebrovascular CO(2) response assessed by transcranial Doppler ultrasonography during propofol anesthesia administration in patients without neurological complications.
Sakai
K
K
Department of Anesthesiology, Nagasaki University School of Medicine, Nagasaki, Japan. d397048@stcc.nagasaki-u.ac.jp
Cho
S
S
Fukusaki
M
M
Shibata
O
O
Sumikawa
K
K
D000328:Adult; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007649:Ketamine; D008297:Male; D020768:Middle Cerebral Artery / Q000502:physiology; D015742:Propofol; D013997:Time Factors; D017585:Ultrasonography, Doppler, Transcranial
D018686:Anesthetics, Intravenous; D002245:Carbon Dioxide; D007649:Ketamine; D015742:Propofol