Page 14 - CASA Bulletin of Anesthesiology 2022; 9(5)

CASA Bulletin of Anesthesiology

mg/ml etomidate. I am reporting the efficacy of analgesia and sedation, and safety profile with
this single syringe multimodal non-opioid KE6-2-2 mixture, focusing on the induction of MAC
for ocular blocks.

Preparation of the KE6-2-2 Mixture (Table 1)
The anesthetic KE6-2-2 mixture contained 6 ml of 10 mg/ml propofol, 2 ml of 10 mg/ml
ketamine, and 2 ml of 2 mg/ml etomidate, in a volume of 10 ml with a ratio of 6-2-2. The volume
was increased to 20 ml or 40 ml depending on surgery length and the patient’s need for sedation.
The total dose of ketamine was limited to 100 mg and etomidate was limited to 20 mg.

For comparison, I also include the combination of the A6-2-2 mixture which contains 6 ml of
10 mg/ml propofol, 2 ml of 0.5 mg/ml alfentanil, and 2 ml of 10 mg/ml lidocaine. The total dose
of alfentanil was limited to 2 mg.

Calculation and Administration of the 6-2-2 Mixture Bolus Dose (Table 1)

The bolus dose for either KE6-2-2 or A6-2-2 mixtures was calculated based on the patient's
age and actual body weight (ABW) if BMI <25 kg/m2 or Adjusted Weight for Dosing (AWFD)
for BMI > 25 kg/m2. Age criteria was as follows: for patients < 40 yrs., 1.2 ml/10 kg; 41-60 yrs.,
1 mL/10 kg; 61-70 yrs., 0.8 mL/10 kg; 71 -84 yrs. 0.6 mL/10 kg; >85 yrs. 0.5 mL/10 kg. The
AWFD was calculated using the formula: AWFD = IBW + 30% (Actual weight - IBW) , where
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IBW was ideal body weight. Calculation of the bolus dose was applied to both non-opioid KE6-
2-2 or opioid-based A6-2-2 mixtures. The bolus dose was administered by hand push or infusion
pump over several seconds.

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