ketafol,any knowledge of?

combination of ketamine and propofol

Every time I swallow, It hurts, I think my throat is swollen is there anything I can do to sooth my throat?

Answers:
It's an anaesthetic.
There is a discussion about it here:

http://www.flightweb.com/forum/viewtopic.php?forum=6&showtopic=1227

Ketamine and propofol are described here:
http://en.wikipedia.org/wiki/Ketamine
http://en.wikipedia.org/wiki/Propofol

Renal failure: urea 139, cretanin 7.1, potassium 5.1?

Other Answers:

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From: reuben j. strayer <emed@MRFANTASY.NET>
Date: Fri May 19 2006 - 00:47:54 PDT

> From: Fergus Thornton <airedale@EARTHLINK.NET>
> Subject: Re: ketamine drips
>
> Is anyone using ketamine drips in trauma? It seems like a
> perfect solution for pain control, sedation, and, if needed,
> induction. I've seen one article on this in, I believe, surg
> lit.

The so-called "micro-drip" technique of total intravenous anesthesia
was well-studied in the 70's, especially in foreign language
journals. They preferred ketamine-diazepam. Ketamine drips have also
been studied for postop pain and chronic pain. I have pasted two
abstracts with specific techniques and could forward you dozens more
if you're interested. The drip-of-the-moment in the ED is ketafol: 5
mg ketamine + 5 mg propofol per cc in the same syringe, given 2-4
cc's prn for procedural sedation; there's no reason why this can't be
made into a drip and it is touted to work like a dream as the
undesirable effects of one cancel out the other. This combination has
also been well-studied in the anesthesia literature and the reports
are very favorable, though many of these subjects are intubated, but
not all. See the third abstract, below.

reub

Anaesthesist 30:3, 111-4 (1981)

Ketamine as continuous intravenous infusion combined with diazepam in
non-abdominal surgery. A randomized double-blind study.

Pedersen, T

Sixty-four women undergoing non-abdominal operations were
anaesthetized with ketamine administered as continuous intravenous
drip combined with diazepam. A double-blind, controlled study was
done to assess the dosage, the cardiovascular stimulation, and
whether psychotomimetic side effects could be reduced. At induction
ketamine was given in a dose of 2 mg/kg in combination with diazepam/
placebo 10 mg i.v. The infusion was maintained at 2-6 mg/min. The
dose of ketamine during the anaesthesia was significantly reduced by
diazepam, from 4.51 mg/min to 3.55 mg/min (p less than 0.001). The
sympathomimetic effect of ketamine was significantly reduced by
diazepam, as the increase in pulse rate as well as in blood pressure
was diminished (p less than 0.05). The frequency of hallucinations
dropped from 30.0% to 2.9% with diazepam, while the total frequency
of psychotomimetic side effects fell from 36.6% to 11.8% (p less than
0.05). As this frequency of the psychotomimetic side effects still
seems to be high with this method, it cannot be recommended to use a
continuous drip of ketamine for routine operations on adults. On the
other hand, ketamine infusion was found to produce favourable
haemodynamic conditions, and this technique seems to be useful in
poor-risk and hypovolaemic patients.

The Pain Clinic 7:2, 125-129 (1994)

Intravenous microdrip infusion of ketamine in subanaesthetic doses
for intractable terminal cancer pain

Ogawa, S, Kanamura, T, Noda, K, Saeki, S, Katsumata, N, Kato, J,
Nakamura, T, Saito, H and Suzuki, H

Fifteen terminal cancer patients with severe pain unrelieved by
conventional analgesic methods were treated by continuous intravenous
microdrip infusion of ketamine in subanaesthetic doses. The solution
consisted of ketamine 0.05 or 0.1 per cent with an electrolyte or
with dextrose 5 per cent. It was infused at a rate of 20 mg/h as a
starting dose and was maintained subsequently at a lesser rate
according to the analgesic effect. Pain in 13 of the 15 patients
decreased from 5.9 +/- 2.0 to 0.3 +/- 0.8 (mean +/- SD) when assessed
on a 10-point Visual Analogue Pain Score. In two patients the
infusion of ketamine was stopped because of moderate hallucinations
in one patient and of deterioration of the general condition due to
the underlying malignancy in the other. Mental or psychological side-
effects of ketamine were controlled by small doses of droperidol. We
recommend this procedure for pain relief in terminally ill patients
with intractable pain.

Aesthetic Plast Surg 23:1, 70-5 (1999)

Propofol-ketamine technique: dissociative anesthesia for office
surgery (a 5-year review of 1264 cases).

Friedberg, BL

Propofol-ketamine technique is a room air, spontaneous ventilation
(RASV), intravenous dissociative anesthetic technique which simulates
the operating conditions of general anesthesia without the increased
equipment requirements or costs. A total of 2059 procedures were
performed on 1264 patients by 38 different surgeons. There were no
hospital admissions for postoperative nausea and vomiting (PONV) or
uncontrolled pain. All patients were pleased with their anesthetic
and no hallucinations were reported. Cost:benefit analysis is
presented as well as discussion of dissociative anesthesia being
exempt from current California law (AB595).

reuben j. strayer
reuben.strayer@mail.mcgill.ca
http://zo.la
Source(s):
listserve for emergencymedicalpractitioners

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