Combination propofol–ketamine anaesthesia in sick neonates

Two critically ill, opioid‐tolerant neonates were anaesthetized using pancuronium and a mixture of propofol (PROP) and ketamine (KET). Three mg of KET were added per ml (10 mg) of PROP in a single syringe and infused at a rate of 100–150 μg·kg −1 ·min −1 of the PROP component (30–45 μg·kg −1 ·min −1 KET). Total doses of 12–15 and 3.6–4.5 mg·kg −1 of PROP and KET, respectively, were administered. Both patients remained haemodynamically stable throughout their surgical procedures. PROP‐KET is a rational and effective combination for intravenous anaesthesia in critically ill neonates who are likely to be opioid‐tolerant when an anaesthesia vaporizer is not readily available.