Decreased intraoral secretions during sedation-analgesia with propofol-ketamine and midazolam-ketamine combinations.

Purpose: To investigate salivary flow over time with a balanced sedation-analgesia technique using a propofol-ketamine (PK) or a midazolam-ketamine (MK) combination in human volunteers.

Methods: In the PK group, boluses of 1 mg.kg(-1) of propofol and 0.7 mg.kg(-1) of ketamine were initially administered. This was followed by an infusion, given over a 1-h period, of propofol (5 mg.kg(-1)) admixed with ketamine (0.7 mg.kg(-1)). In the MK group, 0.07 mg.kg(-1) of midazolam and 0.7 mg.kg(-1) of ketamine was followed by the infusion of a midazolam (0.07 mg.kg(-1)) and ketamine (0.7 mg.kg(-1)) admixture, also given over a period of 1 h. Salivary flow was measured prior to and at 10-min intervals during the sedation-analgesia, as well as for 30 minutes after its termination.

Results: Mixed intraoral secretions were significantly reduced, by 43% and 47%, on average, in the PK and MK groups, respectively, when compared with presedation levels, and had not returned to baseline levels 30 min after discontinuation of the infusion.

Conclusion: Sedation-analgesia with PK and MK combinations controls intraoral secretions by reducing salivary flow.