title: Deep sedation in GreenLight laser prostatectomy.
abstract: BACKGROUND
  Evaluation of ketamine and propofol combination for the performance of photoselective vaporization of prostate (PVP).
  
  
  METHODS
  Twenty-six patients undergoing PVP for benign prostatic hyperplasia were included in the study. Co-morbidities were present in 24 patients. Midazolam 2 mg intravenous was administered for the induction to anesthesia. Propofol (10 mg/ml) and ketamine (1 mg/ml) were administered with the use of two pumps. An initial bolus dose of 0.03 ml/kg of propofol and 5 mg of ketamine was administered intravenously. The anesthesia was maintained by continuous infusion of 0.01 ml/kg/min of propofol and 2 ml/min of ketamine. Fentanyl was administered when deemed necessary. The level of sedation, peri-operative parameters and side-effects were recorded.
  
  
  RESULTS
  The average periods from the induction of anesthesia and intraoperative infusion were 12.38 ± 5.84 min and 59.5 ± 22.15 min, respectively. Average propofol and total ketamine dose were 85.5 ± 10.62 μg/kg/min and 144.9 ± 45.62 mg, respectively. The average dose of fentanyl administered was 29.81 ± 27.40 μcg. An average period between the end of the infusion and the discharge to the urology clinic was 34.62 ± 22.89 min. Ten patients experienced nausea and five eventually vomited. Hallucinations were observed in five cases while visual disturbances in two patients.
  
  
  CONCLUSIONS
  The combined use of ketamine and propofol for the performance of PVP proved to be an efficient method for anesthesia. The "deep sedation" provided by these drugs was not associated with significant side-effects. Moreover, the use of the above method is indicated in patients with significant co-morbidities that should undergo PVP.
authors.affiliation: Department of Anesthesiology, University of Patras, Greece.
authors.forename: Fotini
authors.initials: F
authors.lastname: Fligou
authors.affiliation: Department of Urology, University of Patras, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kallidonis
authors.affiliation: Department of Anesthesiology, University of Patras, Greece.
authors.forename: Nicolaos
authors.initials: N
authors.lastname: Flaris
authors.affiliation: Department of Urology, Armed Forces Hospital Southern Region, Khamis Mushait, Kingdom of Saudi Arabia.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Al-Aown
authors.affiliation: Department of Urology, University of Patras, Greece.
authors.forename: Iason
authors.initials: I
authors.lastname: Kyriazis
authors.affiliation: Department of Urology, University of Patras, Greece.
authors.forename: Marinos
authors.initials: M
authors.lastname: Vasilas
authors.affiliation: Department of Urology, University of Patras, Greece.
authors.forename: Vasilis
authors.initials: V
authors.lastname: Panagopoulos
authors.affiliation: Department of Urology, University of Patras, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Perimenis
authors.affiliation: Department of Urology, University of Patras, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Liatsikos
authors.affiliation: Department of Anesthesiology, University of Patras, Greece.
authors.forename: Theofanis
authors.initials: T
authors.lastname: Vrettos
keywords: Ketamine; ketofol; laser prostatectomy; photoselective vaporization; propofol; prostate; sedation