Haemodynamic effects of propofol-ketamine and propofl-fentanyl combinations for total intravenous anaesthesia for short surgical procedures

Abstract

Background: Various methods have been tried in preventing haemodynamic instability caused by propofol when combined with other intravenous analgesic agents, because itlacks analgesic property. Hence, it becomes necessary for propofol to be used in combination with other intravenous analgesic agents.

Aim: The aim of the study was toevaluate thehaemodynamic effects of propofol-ketamine and propofol-fentanyl for total intravenous anaesthesia in short surgical procedures.

Patients and Methods: This was a randomized double-blinded trial prospective study of all adult patients aged 18-50 years of either gender with ASA I and II, scheduled for elective short surgical proceduresat the AminuKanoTeaching Hospital, Kano. The clinical and demographic data were gathered from the patient's case note and the proforma of the study. Patients enrolled into the study were randomly allocated into two groups K and Fcomprised of 54 patients each. Group K received propofol-ketamine, whilegroup F received propofol-fentanyl for induction and maintenance of anaesthesia. The HR, SBP andDBP were recorded before and 1min after induction of anaesthesia, 5 minutes till the end of procedure and at recovery till the patients were fully recovered.

Results: There was no statistically significant difference with respect to ages, weight and sex between the two groups (P>0.05). The M: F ratio was 1.8:1 in group K and 2.4:1 in group F (p=0.68). The types of surgical procedures were comparable between the two groups (P>0.05). There was an increase in the mean PR in groups K and F at induction of anaesthesia but the increase in group K was higher than the group F (p=0.01). The SBP in group F showed a statistically significant lower value compared to group K after induction of anaesthesia (p=0.01). There was a fall in DBP during induction of anaesthesia in both groups, but the DBPin group F was significantly lower compared to group K (p=0.01).

Conclusion: Both propofol-ketamine and propofol-fentanyl combinations produced safe and effective anaesthesia withfew side effects. Propofol-ketamine results in a more stable haemodynamicprofile.

Keywords: Propofol, fentanyl, ketamine, short surgical procedures