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[Recovery following anesthesia with diazepam-ketamine and fentanyl-methohexital]
C Sandoval1, G Toullat, J M Desbordes
1Département d'Anesthésie-Réanimation, Hôpital Jean Bernard, Poitiers.
Abstract:
The quality of recovery from general anaesthesia for day-case surgery is assessed by the Trailmaking test in a randomized study of 100 women scheduled for termination of pregnancy on an outpatients basis. All patients are in ASA group I or II. Recovery following diazepam-ketamine based anaesthesia is compared to that following fentanyl-methohexital based anaesthesia. In group A, 5 min after intravenous injection of diazepam (0,2 mg.kg-1), anaesthesia is induced with ketamine (1 mg.kg-1). If necessary, in response to spontaneous movement, for maintenance of anaesthesia, 1 or 2 supplementary doses of ketamine (0,5 mg.kg-1) are administered. In group B, 5 min after intravenous injection of fentanyl (1 microgram.kg-1), anaesthesia is induced with methohexital (2 mg.kg-1). If necessary, in response to spontaneous movement, for maintenance of anaesthesia, 1 or 2 supplementary doses of methohexital (0,7 mg.kg-1) are administered. The quality of recovery is assessed by Trailmaking test 1/2 h and 1 h after surgery and compared with pre-anaesthetic score. The two groups are comparable with regard to age, weight, educational level and average duration of anaesthesia. In group A, the mean score for the two parts of the test is not significantly different 1 h after surgery from the pre-anaesthetic score. In group B, the mean score for the two parts of the test is not significantly different 1/2 h after surgery than the pre-anaesthetic score. This better post-anesthetic score is explained by a learning effect of the test when used several times.(ABSTRACT TRUNCATED AT 250 WORDS)
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