[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--20. Summary of three thousand cases and the future of this anesthetic method].

Total intravenous anesthesia with droperidol, fentanyl and ketamine (DFK) was given to over three thousand patients during four years from April 1989 through March 1993. The patients ranged in age from three months to eighty seven years. They underwent surgical, orthopedic, gynecological, thoracic, plastic and otolaryngeal surgeries, but patients who underwent craniotomy and obstetric operations were excluded. None of them developed any serious complications primarily due to DFK. DFK has many advantages such as the broad safety margin for three agents employed in DFK, no accident by N2O, no air pollution, empty bowels, no increase in middle ear pressure etc, while this has disadvantages such as high blood pressure, slow awakening from anesthesia and unpleasant dreams. Calcium channel blockers are very effective for antagonizing high blood pressure, and rapid recovery from anesthesia can be easily obtained by reducing ketamine dose given and also by application of epidural block. Intraoperative dreams may be avoided by concomitant use of benzodiazepines. Thus we are convinced that DFK can be a good as well as convenient anesthetic method for clinical anesthesia.