• R I Katz, R S Lagasse, A Levy, and G Alexander.
• Department of Anesthesiology, State University of New York, Stony Brook 11794-8480.
• J Clin Anesth. 1993 Mar 1;5(2):134-40.

Study ObjectiveTo examine three commonly used anesthetic induction regimens (thiopental sodium, ketamine, and thiopental plus fentanyl) and one newly described regimen (ketamine plus fentanyl) with respect to hemodynamic stability and patient satisfaction.DesignRandomized, double-blind study.SettingUniversity-affiliated Veterans Administration Hospital.PatientsForty-eight ASA physical status I and II patients (47 males, 1 female) scheduled for surgery requiring general anesthesia.InterventionsPatients were randomized to one of four groups to receive intravenous injections of thiopental 5 mg/kg (Group 1), ketamine 1.5 mg/kg (Group 2), thiopental 3 mg/kg plus fentanyl 4 to 6 micrograms/kg (Group 3), or ketamine 0.5 mg/kg plus fentanyl 4 to 6 micrograms/kg (Group 4) for induction of anesthesia.Measurements And Main ResultsHeart rate (HR) and mean arterial pressure (MAP) were measured during anesthetic induction. Evaluation of patient satisfaction/dissatisfaction and pleasantness/unpleasantness by the Anesthesia Experience Rating (AER) was carried out the day following surgery. Groups 3 and 4 showed the least increase from their baseline values in both HR and MAP after tracheal intubation, but only Group 4 exhibited no statistically significant change in hemodynamic parameters after induction but before intubation (p < 0.05). AER showed a higher level of pleasantness in Group 3 as compared with Group 2 (p < 0.03) and higher levels of satisfaction in Groups 3 (p < 0.03) and 4 (p < 0.02) as compared with Group 2.ConclusionThe combination of ketamine plus fentanyl provides superior hemodynamic stability with excellent patient satisfaction.

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