الفهرس 
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Abstract
This study was designed to evaluate the haemodynamic and recovery characteristics during ketamine-midazolam and propofol-sufentanil anesthesia.
Forty patient were included in this study (ASA I, II & III) of either sex with age ranging from 25-65 years. The patients were scheduled for ambulatory endoscopic biliary procedures.
Patients were classified into two groups (each of twenty) according to the anesthetic technique:
The first group: Patients were premeditcated with 3 mg midazolam. Total intravenous anesthesia was induced by ketamine 1-2 mg Kg.-1 I.V bolus dose. Anesthesia was maintained by ketamine infustion in descending schedule rate of 80-20ug.kg-1. min.
The second group: Patients were premedicated with sufentanil 0.15-0.3 ug. kg-1. Total intravenous anesthesia was induced by propofol 2-2.5 mg. Kg-1. I.V. bolus dose. Anesthesia was maintained by propofol infusion in descending schedule rate of 150-20 ug.kg-1. min-1
Routine intraoperative monitoring with ECG, noninvasive automated arterial blood pressure measurement and pulse oximetry was performed every 5 minutes. The endoscopist satisfaction was recorded. After undergoing the endoscopic procedure, patients were transported to postanesthestic care unit (PACU) where modified Aldrete score (table 1), was used to evaluate the patient every 5 minutes. A score of 9 or more was the discharge score from PACU to the ward.
Using the modified Post-Anesthetic Discharge Score System (modified PADSS) (Table 2), patients were scored in the ward every 30 minutes, until the patients modified PADSS score was 9. The time taken to obtain a modified PADSS 9 was recorded.Discharge time (length of time that elapses from the end of surgery until a patient is discharged home after outpatient surgery) was recorded. Patients who had a modified PADSS score <9 and postoperative symptoms that prevented their discharge within 3 hours after anesthesia, were classified as having persistent symptoms. The reasons for persistent symptoms delaying discharge were recorded.
There was perioperative stability of mean arterial blood pressure coupled with modest decrease in heart rate in both groups.Discharge time was longer in ketamine group than in propofol group.
We conclude that propofol can be regarded as the drug of choice for most of the patients while ketamine may be preferable to propofol in certain critically ill patients (e.g. acute cholangitis).