Comparative Evaluation of Effects of Propofol and Ketamine versus Dexmedetomidine and Ketamine on Blood Pressure, Heart Rate and Recovery of Patients undergoing Dilatation and Curettage

Cardiovascular stability and fast recovery are fundamentals of anesthesia for day care surgery. Dilatation and curettage is a commonly performed minor surgery in obstetrics and gynecology. Propofol is well-studied agent in short surgical procedures. Dexmedetomidine, popular for conscious and cooperative sedation is being used for minor gynecological procedures nowadays. Objective: To compare the effects of propofol and ketamine combination with dexmedetomidine and ketamine combination on cardiovascular parameters and recovery of patients undergoing dilatation and curettage. Methods: In a quasi-experimental study from March 2021 to August 2021, 136 patients admitted for dilatation and curettage under anesthesia were enrolled. Patients were divided into two groups. Group P+K received intravenous propofol and ketamine and Group D+K received intravenous dexmedetomidine and ketamine. During the procedure, blood pressure, heart rate, oxygen saturation, and recovery time were noted in both groups. Results: The demographic data were comparable in both groups. Group P+K had significantly higher heart rate at 5, 10, 15 min, and at the ending of the procedure as compared to group D+K. Group D+K had significantly higher systolic and diastolic blood pressure at 2 min, 5 min, 10 min, 15 min and at procedure end in comparison with group P+K. Bradycardia was observed in 62 (91.2%) patients in D+K group whereas, in P+K group, hypotension was observed in 16 (23.5%) patients. The mean time to attain MAS (modified aldrete score) of 10 in group P+K was 32.0 ± 2.1 minutes whereas in group D+K was 41.3 ± 2.6 minutes. Conclusions: It was concluded that the use of dexmedetomidine and ketamine in dilatational and curettage provides cardiovascular stability without respiratory depression as compared to propofol and ketamine.