Journal of Obstetric Anaesthesia and Critical Care (Jan 2015)
A comparison of two different proportions of ketofol with fentanyl-propofol for sedoanalgesia for tubal sterilization by minilaparotomy: A randomized double-blind trial
Abstract
Background: Ketofol is a combination of ketamine and propofol in a single syringe which can be prepared in any desired concentration. Several gynecological procedures like tubal sterilization are of short duration and just require analgesia and moderate sedation. A study was conducted to compare two different proportions of ketofol, with reference to the duration and level of sedation, quality of analgesia, hemodynamic and respiratory profiles, and to compare all the above effects with the well-tried propofol-fentanyl combination. Materials and Methods: This prospective randomized double-blind study was conducted on 60 adult females scheduled for elective tubal sterilization by minilaparotomy. Patients received a slow bolus injection followed by small aliquots of ketofol containing ketamine: Propofol (1:1) (group A), ketamine: Propofol (1:2) (group B), and fentanyl: Propofol (group C) to a predetermined sedation level using Ramsay Sedation Scale. Vital signs, oxygen saturation, and incidence of any side effects were recorded. Results: Ketofol in groups A and B was comparable in onset of sedation (A: 1.59 ± 0.58 min, B: 1.60 ± 0.72 min), intraoperative sedation scores (A: 5.60 ± 0.5, B: 5.85 ± 0.3), and recovery times (A: 4 ± 1 min, B: 3.5 ± 0.67 min). There was no significant difference in the hemodynamic and respiratory profile of ketofol in groups A, B, and C. Considering the onset of sedation, intraoperative sedation score, and recovery time, group C (fentanyl-propofol) patients were less sedated than their counterparts in ketofol group A and B. Furthermore, considering the verbal rating scale for pain at 15 min postoperatively, group C patients had poor analgesia compared to group A and B. Conclusion: Though ketofol in a ratio of 1:2 provides better sedation level compared to the other groups, both ketofol ratios (1:1 and 1:2) were similar in terms of providing hemodynamic and respiratory stability and producing adverse effects.
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