A comparative study of total intravenous anesthesia with propofol/ketamine and propofol/tramadol combinations in orthopedic outpatient procedures

Background: Propofol opioid/nonopioid combinations provide adequate analgesia during and after surgery. The aim of this study was to compare the effect of anesthesia with propofol/ketamine versus propofol/tramadol on the haemodynamic parameters and pain in patients undergoing orthopaedic outpatient surgical procedures.Methods: Fifty patients with ASA status I-II between the age group of 20-50 years undergoing orthopaedic outpatient surgical procedures under general anesthesia were randomly assigned to propofol/ ketamine (n=25, group I) and propofol/ tramadol (n=25, group II) groups. Patients in group I were induced with propofol 150 μg/kg/min IV and ketamine 50 μg/kg/min IV and in group II induction was performed with propofol 150 μg/kg/min IV and tramadol 1 mg/kg/min. IV. The hemodynamic parameters, oxygen saturation (SpO2), respiration rate, sedation and pain were measured before and after induction at predefined time points and were compared between groups.Results: There was significant difference between groups in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR). SBP, DBP and HR were stable in patients induced with propofol/ketamine. The SBP, DBP and HR decreased significantly after induction with propofol/tramadol compared to premedication, but tends to return to normal after 25 minutes. No significant changes in SpO2 found in both the groups at all-time points. Both groups are sedated and showed no difference in pain score with few episodes of unpleasant dreams or hallucinations or adverse complications.Conclusions: Propofol/tramadol anesthesia in patients undergoing orthopaedic procedures provided stable hemodynamic and respiratory stability, sedation and pain reduction as effective as propofol/ketamine anesthesia.