The comparison of ketamine-thiopental and ketamine-midazolam combinations for ceasarean section anaesthesia

The choice of anaesthetics for ceasarean sections is important for both the nevvborn and the mother. Emergence phenomena (EP) is observed with clinical doses of ketamine that can be avoided with lower doses. Ketamine- thiopentone or ketamine-midazolam combinations were used for ceasarean section anaesthesia induction. Side effects and newborn APGAR scores were evaluated. After institutional approval and informed consent 42 women (ASA I) were randomly allocated to two groups . Group I (n=21) recieved induction doses of IV ketamine 1mg/ kg+thiopentone 3mg/kg, group II (n=21) recieved ketamine 1 mg/kg+midazolam 0.2mg/kg. Both groups were in- tubated with IV1-1.5mg/kg succinylcholine. The patients were ventilated with 100% 02 until the umblical cord was clamped. Anaesthesia was maintained with 50%02+50%N20, 1-1.5% isoflurane and atracurium. Heart rate, ar- terial pressures were recorded before the operation, induction, skin incision and perioperatively. The APGAR sco­ res were evaluated at the first and 5th minutes. The patients were intervieved 12 hours postoperatively for EP. The data was analysed with Student's t test. The two groups were hemodynamicaly comparable (p>0.05). EP was observed in 2 patients of group I. The APGAR scores were similar in both groups (p>0.05). Both anaesthetic combinations shovved similarity in APGAR scores and anaesthesia. Because of its fewer side effects ke- tamine+midazolam combination is more favourable.