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Ketamine anesthesia for laparoscopy.  Keith L, Stepto RC, Bozorgi N, Havdala HS, Prenzlau MS, Salvo B.

A total of 57 patients were selected for ketamine anesthesia during laparoscopy. Of these 45 underwent bilateral partial salpingectomy for sterilization, 7 had diagnostic laparoscopy, and 5 a combination of dilation and curettage and sterilization.

All were given meperidine HCl, 50 mg, and atropine sulfate, .4 mg, shortly before surgery.

Most were also given hydroxyzine hydrochloride, 50 mg, or occasionally 75 mg. A few received valium, 10 mg, instead.

Total average dose of ketamine was 431 mg, with a range of 225-1093 mg. Only 1 patient received over 1 gm.

Statistical analysis of data showed that time of anesthesia rather than weight of the patient was the more important factor in determining dosage. Initial dose of ketamine was about 1 mg per pound of body weight, given iv. For maintenance, at 5-10 minute intervals amounts half the original dose were used. Average operating time was 45 minutes. Effective anesthesia was produced for the duration of the procedure.

• 2 patients had laryngospasm,
• 2 had postoperative hallucinations,
• 1 had postoperative confusion and irrational behavior, and
• 1 patient developed tachycardia.

Transient elevations of blood pressure were the rule. Advantages of ketamine anesthesia are claimed to be: special selective effect on pain perception, stimulation of cardi ovascular system, antiarrhythmic properties, increase of reflexes, patent airway, and more natural appearance of the patient.