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  • Title: Reduction of psychotomimetic side effects of Ketalar (ketamine) by Rohypnol (flunitrazepam). A randomized, double-blind trial.
    Author: Freuchen I, Ostergaard J, Kühl JB, Mikkelsen BO.
    Journal: Acta Anaesthesiol Scand; 1976; 20(2):97-103. PubMed ID: 7095.
    Abstract:
    A double-blind controlled trial based on 140 women undergoing abortus provocatus was employed to study whether the frequency of side effects after administration of the anaesthetic Ketalar (ketamine) could be reduced by a con-current dose of Rohypnol (flunitrazepam). The control group was given ketamine alone. The dosage of ketamine was 2 mg/kg body weight, supplemented if necessary by 1 mg/kg, in combination with either 2 mg flunitrazepam or placebo. No other anaesthetics were used. On several counts, the combination of ketamine and flunitrazepam was proved to reduce the adverse reactions seen with ketamine alone. Motor restlessness and confusion in the awakening state occurred with significantly less severity and frequency. Amnesia for dreams was significantly more frequent. Memory of dreams was often unpleasant after ketamine alone. The influence on pulse rate was significantly smaller and no significant changes in systolic blood pressure were seen, whereas a significant increase occurred with ketamine alone. Less pronounced fluctuations in diastolic blood pressure occurred with the combination ketamine-flunitrazepam. Respiratory rate increased significantly with both treatments, but respiratory minute volume was lower with the ketamine-flunitrazepam combination. A double-blind comparison of ketamine (Ketalar) and ketamine with flunitrazepam (Rohypnol) for anesthesia in 136 abortions was conducted to see whether the combination would reduce the psychomimetic side effects of ketamine. Doses were ketamine 2 mg/kg body weight iv, mixed with 2 mg flunitrazepam or a placebo, and 1 mg/kg ketamine repeated if needed. The side effects significantly reduced were: motor restlessness, confusion requiring sedatives, dreams and nightmares, systolic and diastolic hypertension, tachycardia, and increase in respiratory rate and in respiratory minute volume. Those given ketamine alone required significantly more repeat injections.
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