Comparison of Infusion of Propofol and Ketamine-Propofol Mixture (Ketofol) as Anesthetic Maintenance Agents on Blood Pressure of Patients Undergoing Orthopedic Leg Surgeries

Abstract

Background: Some studies have reported the effects of anesthesia induction using a single propofol dose and low ketamine doses in short-term outpatient operations. Objectives: In this study, we aimed to evaluate the intra and post-operative hemodynamic effects of ketamine-propofol mixture (Ketofol) infusion in comparison with propofol infusion. Methods: This study was performed on 54 class I and II of the American Society of Anesthesia patients aged 15 to 45 years who were candidates for leg fracture surgery. The patients were randomly assigned to propofol and ketofol groups. In the propofol and ketofol groups, propofol infusion (100 µg/kg/min) and propofol-ketamine infusion (50 µg/kg/min propofol + 25 µg/kg/min ketamine) were used for the maintenance of anesthesia, respectively. Heart rate and systolic, diastolic and mean blood pressure before, immediately after the induction of anesthesia and at 10-minute intervals were measured and recorded. Pain, nausea, and vomiting were recorded immediately after surgery and each 2 hours until 6 hours. Results: Systolic, diastolic and mean blood pressure were significantly higher in the ketofol group than in the propofol group at 10 -60 min intervals (P < 0.05). There was no significant difference, however, between the two groups in terms of the severity of nausea and pain and vomiting frequency. Conclusions: Infusion of hypnotic doses of ketofol leads to increase in diastolic and systolic blood pressure and improves blood pressure stability in addition to inducing more as compared with propofol infusion, but it leads to higher risk of nausea and vomiting.

Clinico-Physiological Effects of Ketofol 1:2 in Canine Orthopaedic Patients

“…Moreover atropine and ketamine has synergistic in accordance with increased heart rate (Thejasree et al, 2018). Similar trend heart rate noticed in ketofol 1:2 on human orthopaedic patients when compared with cri of propofol (Sabertanha et al, 2019). Oxygen saturation of haemoglobin evidences that significant drop at induction and immediately after induction.…”

A case report: Anesthetic management for open‐heart surgery in a child with congenital insensitivity to pain with anhidrosis

“…Rapid induction followed by tracheal intubation is preferred. Ketamine inhibits serotonin uptake at synaptic terminals 9 and increases the risk of nausea and vomiting, which may lead to regurgitation and aspiration 10,11 . Therefore, it should be avoided for anesthesia induction.…”

“…Ketamine inhibits serotonin uptake at synaptic terminals 9 and increases the risk of nausea and vomiting, which may lead to regurgitation and aspiration. 10,11 Therefore, it should be avoided for anesthesia induction. The patient should be fasted for 6 h according to age.…”

Reliable and Rapid Smooth Extubation After "Ketamine-Propfol Mixture" for Induction of General Anesthesia in Laparoscopic Drilling of Polycystic Ovary: A Randomized, Double-Blind, Comparative Study

“…Our results are in agreement with those of Aboeldahab et al, as ketofol was associated with more stable hemodynamics than propofol during extubation. Also, Sabertanha A et al, in their study, deduced that the infusion of a combination of ketamine and propofol increased hemodynamic stability and was superior in analgesia compared to the infusion of only propofol ( 20 ). We attributed this to the good sedation level of ketofol during suction and extubation due to the additive analgesic and sedative effect of ketamine and propofol.…”