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Ketamine Compared With Fentanyl for Surgical Abortion: A Randomized Controlled Trial
Jennifer Chin1, Madeline McGrath, Erica Lokken
1Department of Obstetrics and Gynecology, the School of Medicine, and the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
Obstetrics and Gynecology
|August 4, 2022
Summary
Intravenous ketamine is as effective as intravenous fentanyl for patient satisfaction during first-trimester surgical abortion sedation. This study found ketamine noninferior to fentanyl for anesthesia satisfaction in outpatient procedures.
Area of Science:
- Anesthesiology
- Gynecology
- Pharmacology
Background:
- Procedural sedation is crucial for patient comfort during first-trimester surgical abortions.
- Intravenous ketamine and fentanyl are commonly used agents for procedural sedation.
- Comparing patient satisfaction between these agents is important for optimizing care.
Purpose of the Study:
- To compare patient satisfaction with anesthesia after first-trimester surgical abortion.
- To evaluate the noninferiority of intravenous ketamine compared to intravenous fentanyl for procedural sedation.
Main Methods:
- A randomized noninferiority trial was conducted with 110 patients undergoing first-trimester surgical abortion.
- Patients received either intravenous ketamine or intravenous fentanyl for procedural sedation, along with midazolam.
- Patient satisfaction was measured using the Iowa Satisfaction with Anesthesia Scale postprocedure.
Main Results:
- Patient satisfaction was noninferior in the ketamine group (mean score 2.4) compared to the fentanyl group (mean score 2.2).
- Hallucinations were reported more frequently in the ketamine group.
- Secondary outcomes, including pain and time to discharge, were similar between groups.
Conclusions:
- Intravenous ketamine is a viable alternative to intravenous fentanyl for procedural sedation in first-trimester surgical abortions.
- Ketamine provides comparable patient satisfaction with anesthesia.
- Further research may explore managing side effects like hallucinations with ketamine.
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