title: [Sedation and analgesia with propofol plus low-dose ketamine for retrobulbar block].
abstract: OBJECTIVE
  To determine if adding ketamine to propofol provides better sedation than propofol alone for patients receiving a retrobulbar block for eye surgery.
  
  
  METHODS
  Randomized double-blind trial enrolling 50 patients receiving a retrobulbar nerve block for eye surgery. Patients were randomly assigned to 2 groups. In the propofol group sedation was induced with 0.45 mg x kg(-1) of propofol. In the ketamine plus propofol group sedation was induced with 0.45 mg x kg(-1) of propofol plus 0.25 mg x kg(-1) of ketamine. We recorded patient characteristics (age, weight, ASA class, height, sex), hemodynamic variables (blood pressure, heart rate), puncture conditions, sedation (score on the Observer's Assessment of Alertness/Sedation [OAA/S] scale), ventilation (end-tidal carbon dioxide pressure, apneas, need for reanimation maneuvers, pulse oximetry), time until onset of effect, duration of effect, and amnesia.
  
  
  RESULTS
  No significant differences were observed in time to onset, duration of effect, patient characteristics, hemodynamic or respiratory variables, or amnesia. Sedation assessed on the OAA/S-scale was lower in the propofol group and the puncture conditions were significantly better in the ketamine plus propofol group. The only adverse psychomimetic reaction was transient agitation, observed in 2 propofol group patients.
  
  
  CONCLUSIONS
  Low doses of ketamine associated with propofol improve puncture conditions for performing a retrobulbar block without increasing unwanted side effects.
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Mar-Esperança, IMAS, Barcelona. 90409@imas.imim.es
authors.forename: X
authors.initials: X
authors.lastname: Santiveri
authors.forename: L
authors.initials: L
authors.lastname: Moltò
authors.forename: C
authors.initials: C
authors.lastname: Rodríguez
authors.forename: F
authors.initials: F
authors.lastname: Sandín
authors.forename: J
authors.initials: J
authors.lastname: Vilaplana
authors.forename: J
authors.initials: J
authors.lastname: Castillo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017109:Akathisia, Drug-Induced / Q000209:etiology; D000556:Ambulatory Surgical Procedures; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000009:adverse effects; D000778:Anesthetics, Dissociative / Q000008:administration & dosage* / Q000009:adverse effects; D002387:Cataract Extraction; D016292:Procedural Sedation / Q000379:methods*; D004311:Double-Blind Method; D004357:Drug Synergism; D005260:Female; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007649:Ketamine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D009407:Nerve Block / Q000379:methods*; D013508:Ophthalmologic Surgical Procedures; D009915:Orbit; D011183:Postoperative Complications / Q000139:chemically induced; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012163:Retinal Detachment / Q000601:surgery
chemical_list: D018712:Analgesics, Non-Narcotic; D000778:Anesthetics, Dissociative; D006993:Hypnotics and Sedatives; D007649:Ketamine; D015742:Propofol