title: Anesthesia with ketamine, propofol, and fentanyl decreases the frequency of postoperative psychosis emergence and confusion in schizophrenic patients.
abstract: OBJECTIVE
  To investigate whether total IV anesthesia with ketamine, propofol, and fentanyl affects the frequency of postoperative psychosis emergence or confusion in schizophrenic patients.
  
  
  METHODS
  Prospective, controlled study.
  
  
  METHODS
  Hirosaki National Hospital and Hakodate Watanabe Hospital.
  
  
  METHODS
  76 ASA physical status I and II schizophrenic patients taking chronic antipsychotic drugs and schedule for orthopedic surgery of extremities.
  
  
  METHODS
  In Group A (n = 38) patients, anesthesia was maintained with sevoflurane, nitrous oxide, and fentanyl. In Group B (n = 38) patients, anesthesia was maintained with ketamine, propofol, and fentanyl.
  
  
  RESULTS
  The frequency of psychosis emergence or confusion (54%) in Group A during the first 48 hours after surgery was significantly higher than the 30% figure in Group B.
  
  
  CONCLUSIONS
  Ketamine, when combined with propofol and fentanyl, is an appropriate anesthetic drug for schizophrenic patients.
authors.affiliation: Department of Anesthesiology, Hirosaki National Hospital, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kudoh
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Katagai
authors.forename: Tomoko
authors.initials: T
authors.lastname: Takazawa
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D000778:Anesthetics, Dissociative / Q000009:adverse effects; D018686:Anesthetics, Intravenous; D003221:Confusion / Q000139:chemically induced / Q000517:prevention & control*; D005260:Female; D005283:Fentanyl; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D007649:Ketamine / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000523:psychology*; D015742:Propofol; D011446:Prospective Studies; D011605:Psychoses, Substance-Induced / Q000209:etiology / Q000517:prevention & control*; D012565:Schizophrenic Psychology
chemical_list: D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D007649:Ketamine; D005283:Fentanyl; D015742:Propofol