Anesthesia with ketamine, propofol, and fentanyl decreases the frequency of postoperative psychosis emergence and confusion in schizophrenic patients.
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.
Kudoh
Akira
A
Department of Anesthesiology, Hirosaki National Hospital, Japan.
Katagai
Hiroshi
H
Takazawa
Tomoko
T
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
D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D007649:Ketamine; D005283:Fentanyl; D015742:Propofol