Combination propofol-ketamine anaesthesia in sick neonates

Two critically ill, opioid-tolerant neonates were anaesthetized using pancuronium and a mixture of propofol (PROP) and ketamine (KET). Three mg of KET were added per ml (10 mg) of PROP in a single syringe and infused at a rate of 100-150 microg x kg(-1) x min(-1) of the PROP component (30-45 microg x kg(-1) x min(-1) KET). Total doses of 12-15 and 3.6-4.5 mg x kg(-1) of PROP and KET, respectively, were administered. Both patients remained haemodynamically stable throughout their surgical procedures. PROP-KET is a rational and effective combination for intravenous anaesthesia in critically ill neonates who are likely to be opioid-tolerant when an anaesthesia vaporizer is not readily available.