Feasibility Of Dexmedetomidine-ketamine Combination In Knee Arthroscopy

Objective To investigate the feasibility of dexmedetomidine-ketamine combination in knee arthroscopy.Methods50patients with ASA I or II, aged18-60years, scheduled for knee arthroseopy were randomly divided into two groups (25patients in each), In the D-K group, dexmedetomidine (a bolus of1μg·kg-1was administered for10mins, followed by1.5μg·kg-1·h-1infusion during the operation) and ketamine (a bolus of0.5μg·kg-1was administered, followed by1μg·kg-1·h-1infusion during the operation) were applied. In the P-F group, target-controlled infusion of propofol (the target plasma concentration was set at3mg·L-1)and2μg·kg-1fentanyl were given. The observer’s assessment of alertness/sedation (OAA/S) scale, bispectral index (BIS), respiratory rate(RR), end-tidal carbon dioxide tension (PETCO2), mean arterial blood pressure (MAP), pulse oxygen saturation (SpO2) and heart rate(HR) were continuously monitored. Induction time, orientation recovery time and adverse reactions were also recorded. Level of satisfaction with quality of anesthesia was evaluated by patients and surgeons.Results The patients in the group D-K did not have significant respiratory depression (SpO2≥96%and PETCO2remained normal). In the P-F group,19patients (SpO2≤90%) altogether had to insert orophatyngeal airway or give assisted ventilation. Compared with group P-F, the hemodynamic in the D-K group was more stable, but HR decreased significantly when BIS≤60。The induction time and orientation recovery time of D-K group was longer than those of P-F group (P<0.05). There was no significant difference in the level of satisfaction with quality of anesthesia evaluated by patients and surgeons between two groups.Conclusion Dexmedetomidine-ketamine combination has light influence on breathing and more stable hemodynamic and is safe and feasible in knee arthroscopy.