Comparison of the Effects of Ketofol and Ketamine Plus Propofol on Hemodynamic Status of Patients Undergoing Transurethral Lithotripsy

Abstract

Background: In the recent years, many studies have been done on the drug combination of ketamine and propofol (ketofol). Ketamine, due to increase in blood pressure, improves hemodynamic changes of propofol. On the other hand, propofol has antiemetic effects and through strong sedative effect reduces the psychiatric side effects of ketamine. Studies have used the combination of propofol and ketamine (within a syringe) as a new drug called ketofol. Objectives: Because of the possible drug interactions between these two drugs, this study was conducted to compare the effects of ketofol with the effect of ketamine plus propofol on hemodynamic status of patients undergoing transurethral lithotripsy (TUL). Methods: This quasi-experimental study was carried out on patients undergoing TUL, during year 2015. After considering the inclusion and exclusion criteria, the sample size for each group was determined as 20 subjects, who were randomly assigned to one of the treatment groups. In the patients of the ketofol group, 1 mg/kg of propofol and 1 mg/kg of ketamine were drawn in a syringe and then injected. In the patients of ketamine plus propofol group, 1 mg/kg of propofol and 1 mg/kg of ketamine was drawn in separate syringes and were injected consecutively. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and arterial blood oxygen-saturated hemoglobin (O2Sat) were recorded at 1, 5, 10 and 15 minutes after endotracheal intubation. Data was analyzed using descriptive and analytical statistics (mean, frequency, and Independent t-test). Results: Males constituted 75% of patients. The mean age of participants was 37.34 ± 8.33 years and the age group of 31 to 45 years accounted for the highest percentage. There were no significant differences in mean ± SD of SBP, DBP, MAP, HR, and O2Sat at different times of surgery in the groups of ketofol and ketamine plus propofol. Conclusions: According to the non-significant mean SBP, DBP, MAP, HR, and O2Sat at different times of surgery in the groups of ketofol and ketamine plus propofol, there is no need to combine the two drugs. Thus, possible complications and drug interactions of the combination of ketamine and propofol can be prevented (ketofol).