Sedation with ketamine during cataract surgery

To evaluate the cardiovascular and ocular effects of a low-dose sedation-analgesia regimen in cataract surgery.

Department of Ophthalmology, University of Udine, Udine, Italy.

Eighty patients were randomly assigned to two groups. The first was treated with droperidol 0.03 mg/kg, diazepam 0.06 mg/kg, ketamine 0.3 mg/kg; the second (control), with the same drugs except for ketamine. Heart rate, arterial pressure, and intraocular pressure (IOP) in the fellow eye were measured before and 3 minutes after injection of the sedative mixture. The anesthetic block was then performed.

Heart rate increased in both groups by about 5%. Systolic arterial pressure fell by 15.6 mm Hg +/- 22.3 (SD) in the ketamine group and by 31.7 +/- 17.3 mm Hg (P < .005) in the control group. Intraocular pressure fell in the two groups by 5.24 +/- 2.8 mm Hg and 4.5 +/- 2.5 mm Hg, respectively. None of the ketamine-treated patients reported pain during the administration of anesthesia or postoperatively. Eighty percent of the control group reported pain. In the early postoperative period, no episodes of nausea, emesis, or hallucination were reported.

In a regimen with other drugs, ketamine did not influence IOP and enabled comfortable completion of anesthesia and surgery.