Patient anxiety scores after low-dose ketamine or fentanyl for epidural catheter placement.
OBJECTIVE
To compare the effect of low-dose ketamine with that of low-dose fentanyl on patient anxiety during the identification of the epidural space and catheterization.


METHODS
Sixty patients were randomly assigned to one of three groups: saline group (n=20), saline 2 ml; ketamine group (n=20), 5 mg ketamine; or fentanyl group (n=20), 50 microg fentanyl. Each drug was administered intravenously (iv) five to ten minutes before the epidural procedures began. After epidural catheter placement had been accomplished, anxiety and pain were rated using a visual analog scale.


RESULTS
The anxiety scores given for ketamine(20.2 +/- 18.5, mean +/- SD) and fentanyl (24.6 +/- 20.3) were similar, and both were lower than that for saline (44.1 +/- 32.7) (P=0.0034 and 0.0153 vs saline group, respectively). Pain scores were similar for all three groups. A decrease in hemoglobin oxygen saturation during the procedure was only observed in the fentanyl group, and two patients in fentanyl group had SpO2 <90%.


CONCLUSIONS
Ketamine, 5 mg iv, is as effective as 50 microg fentanyl, iv, in alleviating patient anxiety and in providing adequate sedation during the procedures necessary for epidural catheter placement, without inducing severe complications.
Oda
A
A
Department of Anesthesiology and Critical Care Medicine, Gifu University School of Medicine, Gifu City, Japan.
Iida
H
H
Dohi
S
S
D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D000778:Anesthetics, Dissociative / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D001007:Anxiety / Q000517:prevention & control* / Q000523:psychology*; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D007649:Ketamine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement
D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D007649:Ketamine; D005283:Fentanyl