Ketamine-diazepam anaesthesia in surface and major plastic surgical operations

Ketamine hydrochloride seems to be equally suitable for surface and major plastic surgical operations where controlled ventilation is required. Controlled ventilation performed by less amount of muscle relaxant where patients were ventilated with air only sparing the O2 and N2O. Fifty patients undergoing various operations including major plastic surgery were divided into two groups. In group A, an infusion of 500 mg ketamine hydrochloride, 20 mg diazepam in 500 ml of 5% dextrose was used as anaesthetic and in group B, the same drip was started and pancuronium bromide 0.08 mg/kg IV was given when eyelash reflexes were lost. Mean durations of anaesthesia were 70.4 minutes and 90.2 minutes in groups A and B respectively. Mean doses of ketamine hydrochloride required were 310 mg and 370 mg in groups A and B respectively. Decurarisation was done in usual way in group B patients. The induction, maintenance and recovery were smooth and uneventful in all cases. Moreover no difficulty was encountered in reversing residual curarisation in any of the patients in group B. Mean rise of systolic BP was 12.5 mm Hg and that of pulse rate was 20/minute in group A. In group B, mean rise of systolic BP was 10 mm Hg and that of pulse rate was 16/minute.