Ketamine Induction in Poor-Risk Patients / 대한마취과학회지

ABSTRACT

The induction period in the course of a general anesthetic has its own attendant hazards and is especially problematical for the anesthetist in managing the patient for whom the risk is high. The purpose of this study is to determine if ketamine used as an induction agent in poor-risk patients would induce sudden changes in the cardiovascular or respiratory system. Forty poor-risk patients, falling into class 3 or 4 of the A.S.A. physical status classification, were studied for ketamine induction and rangedoin age from 4 months to 62 years. Anesthesia was induced with intravenous or intramuscular ketamine and subsequent endotracheal intubation was performed with the aid of succinylcholine. Vital signs were recorded every 5 minutes. According to blood pressure and pulse rate measured 5 minutes after giving ketamine, patients were classified into fcur grougs to emphasize the four typical cardiovascular responses to ketamine induction. By observation of vital signs, ketamine induction in 40 poor-risk-patients did not produce any untoward cardiovascular and respiratory effects, and the postanesthetic psychic disturbances were absent. Specifically, in accordance with our observation of vital signs, blood pressure and pulse rate were increased or unchanged by ketamine induction. In conclusion, ketamine as an induction agent is recommended for poor-risk patients, especially those with unstable cardiovascular systems.