Why the study?
Low-dose ketamine may reduce propofol cardiovascular effects but might increase awareness during anesthesia, prompting comparison of ketofol and propofol infusions on intra- and postoperative hemodynamics.
Does ketamine-propofol mixture (ketofol) infusion improve intra and post-operative hemodynamic stability compared to propofol infusion in patients undergoing surgical procedures?
Does ketamine-propofol mixture (ketofol) infusion improve intra and post-operative hemodynamic stability compared to propofol infusion in patients undergoing surgical procedures?
A retrospective study found no significant differences in hemodynamics, pain, or nausea between ketofol and propofol infusions, though the authors concluded ketofol improves stability and analgesia at the cost of increased nausea.
Ketamine-propofol infusion was associated with better hemodynamic stability in ED outpatients; leaves open confirmation via randomized trials.
Introduction: The existing evidence suggests that the use of low doses and titers of ketamine can be effective in reducing the cardiovascular effects of propofol; nevertheless, this administration method can increase the chance of waking up during anesthesia. Some studies have reported the effect of anesthesia induction using a single propofol dose and low ketamine doses on the hemodynamic stability of patients in short-term outpatient operations in emergency departments. The aim of this study is to compare the effect of ketofol and propofol , to evaluate the intra and post-operative hemodynamic effects of ketofol infusion in comparison with propofol infusion. Methods: This Retrospective study involved Prior Consent from the Hospital Authorities & was found to be within ethical standards. Data of 100 surgeries were selected which were managed with propofol ( 50 surgeries ) & ketofol ( 50 surgeries) separately admitted to the local surgical units in last 5 years. The two groups were compared in terms of heart rate, systolic, diastolic and mean blood pressure, severity of pain and nausea, vomiting frequency and the doses of analgesics and antiemetic drugs used. Results: 38 (76%) out of 50 of the patients were male in the propofol group and 31 ( 62%) out of 50 were male in the ketofol group and the difference was not Significant .The mean age of the patients was 39.68 ± 7.32 years in the ketofol and 34.14 ± 7.61 years in the propofol groups . There was no statistical difference between the two groups regarding age and sex distribution. There was no difference between the two groups regarding systolic, diastolic and mean arterial blood pressure before induction and after. The intensity of nausea was not significantly different between the two groups. Postoperative pain severity and drug dosage were not significantly different between the two study groups. Conclusion: The infusion of a mixture of ketamine and propofol improves hemodynamic stability in addition to better analgesia compared to the infusion of propofol alone. But it led to heightened risk of nausea and vomiting. Future studies are recommended to address these issues. In addition, further studies are warranted to investigate the use of sub-hypnotic doses of ketamine + ketofol combination for infusion in surgical procedures. When these parameters are considered, ketofol might be used as an alternative to propofol. Keyword: Ketofol, Propofol, Retrospective Study. Comparative study, Ketamine
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Goel et al. (2020) studied this question.
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