Comparison of Propofol and Ketamine-Propofol Mixture (Ketofol) on Laryngeal Tube-Suction II Conditions and Hemodynamics: A Randomized, Prospective, Double-Blind Trial

Abstract

ObjectiveThe aim of our study is to compare the effect of ketamine–propofol mixture (ketofol) and propofol on the laryngeal tube-Suction II (LTS II) insertion conditions and hemodynamics.MethodsEighty American Society of Anesthesiologists class 1 and 2 patients were divided into 2 random groups to receive either 1 µg/kg remifentanil and propofol 2 mg/kg in Group P (n = 40), or 1 µg/kg remifentanil and ketofol (using a 1:1 single syringe mixture of 5 mg/mL ketamine and 5 mg/mL propofol) in Group K (n = 40) before induction of anesthesia. After induction, LTS II was inserted. Heart rate and noninvasive blood pressure were recorded before induction of anesthesia (t0); immediately following induction (t1); immediately after LTS II insertion (t2); and 3 minutes (t3), 5 minutes (t4), and 10 (t5) minutes after LTS II insertion. Conditions of insertion of LTS II were assessed and scored 1 to 3 using 6 variables as follows: mouth opening, swallowing, coughing, head and body movements, laryngospasm, and ease of LTS II insertion by the same experienced anesthesiologist who did not know the agents. LTS II insertion summed score was prepared depending upon these variables.ResultsIn regard to LTS II insertion summed score, Group K was more favorable than Group P (P < 0.05). Apnea duration was longer in Group P (385.0 seconds [range = 195.0–840.0 seconds]) compared with Group K (325.50 seconds [range = 60.0–840.0 seconds]) but this was not statically significant. The heart rate values were significantly lower at all measurement intervals in both groups compared with the baseline values (P < 0.05). There was no difference in heart rate between Group P and Group K. The mean arterial pressure values were significantly lower at all measurement intervals in Group P compared with baseline values (P < 0.05). In Group K, the mean arterial pressure values were significantly lower at all measurement intervals compared with the baseline values, except t2 (P < 0.05). There was a significant difference between Group P and Group K in terms of mean arterial pressure at t3 (P < 0.05).ConclusionsWe found that ketofol provided better insertion summed score for LTS II than propofol, with minimal hemodynamic changes.

Frequency of excellent Laryngeal mask airway insertion conditions in children undergoing elective surgery: A comparison of propofol with ketofol.

“…They showed significant results with p<0.05 with better insertion of laryngeal tube with minimal adverse airway responses and complications under ketofol (Group K ) induction as compared to propofol (Group P). 18 Goel S. also showed better insertion of LMA in Group PK (ketofol) and Group PM (propofol+midazolam) than in Group P (propofol) 19 which is also confirmed in our study.…”

Effect of Etomidate Versus Combination of Propofol-Ketamine and Thiopental-Ketamine on Hemodynamic Response to Laryngoscopy and Intubation: A Randomized Double Blind Clinical Trial

“…Another study by Ghatak et al showed that addition of ketamine with propofol provides hemodynamic stability in children premedicated using clonidine for insertion of laryngeal mask airway (LMA) ( 21 ). However, Ozgul et al showed that ketamine-propofol combination provided minimal hemodynamic changes during insertion of laryngeal tube-suction ( 22 ).…”

Propofol-ketamine combination: a choice with less complications and better hemodynamic stability compared to propofol? On a prospective study in a group of colonoscopy patients

“…Due to low cardiovascular side effect profile, ketamine is widely used as a combination agent in anesthetic procedures. However, it might delay postoperative recovery [3][4][5][6]. Depending on these previous literature, we hypothesized that using ketamine-propofol combination for colonoscopy procedures might result in shorter sedation achievement duration, lower hemodynamic and respiratory complication rates and less side effects.…”