Anesthesia with ketamine, propofol, and fentanyl decreases the frequency of postoperative psychosis emergence and confusion in schizophrenic patients

Study Objective: To investigate whether total IV anesthesia with ketamine, propofol, and fentanyl affects the frequency of Postoperative psychosis emergence or confusion in schizophrenic patients. Design: Prospective, controlled study. Setting: Hirosaki National Hospital and Hakodate Watanabe Hospital. Patients: 76 ASA physical status I and II schizophrenic patients taking chronic antipsychotic drugs and schedule for orthopedic surgery of extremities. Interventions: In Group A (n = 38) patients, anesthesia was maintained with sevoflurane, nitrous oxide, and fentanyl. In Group B (n = 38) patients, anesthesia was maintained with keta nine, propofol, and fentanyl. Measurements and Main Results: The frequency of psychosis emergence or confusion (54%) in Group A during the first 48 hours after surgery was significantly higher than the 30% figure in Group B. Conclusion: Ketamine, when combined with propofol and fentanyl, is an appropriate anesthetic drug for schizophrenic patients. (C) 2002 by Elsevier Science Inc.