Comparison of effects of propofol and ketofol (Ketamine-Propofol mixture) on emergence agitation in children undergoing tonsillectomy

Afr Health Sci. 2019 Mar;19(1):1736-1744. doi: 10.4314/ahs.v19i1.50.

Abstract

Background: The aim of this study was to compare the effect of propofol and ketofol (ketamine-propofol mixture) on EA in children undergoing tonsillectomy.

Method: In this randomized clinical trial, 87 ASA class I and II patients, aged 3-12 years, who underwent tonsillectomy, were divided into two groups to receive either propofol 100 µg/kg/min (group p, n=44) or ketofol : ketamine 25 µg/kg/min + propofol 75 µg/kg/min (group k, n= 43). Incidence and severity of EA was evaluated using the Pediatric Anesthesia Emergence Delirium (PAED) scales on arrival at the recovery room, and 10 and 30 min after that time.

Results: There was no statistically significant difference in demographic data between the two groups. In the ketofol group, the need for agitation treatment and also mean recovery duration were lower than in the propofol group (30 and 41%, and 29.9 and 32.7 min), without statistically significant difference (P value=0.143 and P value=0.187). Laryngospasm or bronchospasm occurred in 2 patients in each group and bleeding was observed in only one individual in the ketofol group.

Conclusion: Infusion of ketofol in children undergoing tonsillectomy provides shorter recovery time and lower incidence of EA despite the non significant difference with propofol.

Keywords: Emergence agitation; ketofol; propofol.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anesthesia / adverse effects
  • Anesthetics, Dissociative / administration & dosage*
  • Anesthetics, Dissociative / adverse effects
  • Anesthetics, Intravenous / administration & dosage*
  • Anesthetics, Intravenous / adverse effects
  • Bronchial Spasm / chemically induced
  • Child
  • Child, Preschool
  • Emergence Delirium / chemically induced*
  • Emergence Delirium / epidemiology
  • Female
  • Humans
  • Incidence
  • Ketamine / administration & dosage*
  • Ketamine / adverse effects
  • Laryngismus / chemically induced
  • Male
  • Outcome Assessment, Health Care
  • Propofol / administration & dosage*
  • Propofol / adverse effects
  • Severity of Illness Index
  • Tonsillectomy / methods*

Substances

  • Anesthetics, Dissociative
  • Anesthetics, Intravenous
  • Ketamine
  • Propofol