Comparison of haemodynamic changes between propofol and ketofol as induction agents in patients undergoing laparoscopic surgeries under general anaesthesia

Vikasini Raman; Sivakumar Segaran; T Ramyavel; Sagiev Koshy George; Mamie Zachariah

doi:10.4103/joacp.JOACP_251_20

Comparison of haemodynamic changes between propofol and ketofol as induction agents in patients undergoing laparoscopic surgeries under general anaesthesia

J Anaesthesiol Clin Pharmacol. 2022 Apr-Jun;38(2):215-220. doi: 10.4103/joacp.JOACP_251_20. Epub 2022 Jan 13.

Authors

Vikasini Raman¹, Sivakumar Segaran¹, T Ramyavel¹, Sagiev Koshy George¹, Mamie Zachariah¹

Affiliation

¹ Department of Anaesthesiology and Critical Care, Pondicherry Institute of Medical Sciences, Puducherry, India.

Abstract

Background and aims: Laparoscopic surgeries are more commonly performed procedure nowadays because of its advantages however generation of pneumoperitoneum causes significant physiological changes. Propofol is the most commonly used induction agent but its use is limited by its side effects like dose-dependent hypotension and myocardial depression. So by combining propofol with ketamine to form ketofol may result in better hemodynamic stability. The aim of this study was to compare the haemodynamic changes in patients undergoing laparoscopic surgery under general anesthesia using propofol and ketofol as induction agents.

Material and methods: In this prospective randomized double blind study, 80 patients of ASA I/II undergoing elective laparoscopic surgery were randomized into two Groups. Group A received 1 mg/kg of propofol + 1 mg/kg ketamine made up to a total volume of 20 ml with normal saline and Group B received 2 mg/kg propofol + normal saline to make up to an equal volume. Hemodynamic profiles like HR, SBP, DBP, and MAP were recorded at different time intervals until pneumoperitoneum. Postoperative recovery profile and complications were recorded. All data were entered in MS excel and analyzed using SPSS Version 20.0. Repeated measures ANOVA and Chi-square test were used to test the level of significance.

Results: Demographic character and duration of surgery were comparable. SBP, DBP, MAP and HR showed statistically significant difference in both groups in various time intervals with P < 0.05 with Group A (ketofol ) having a better hemodynamic stability. Recovery profile in ketofol group took longer duration (4.95 min) compared to propofol group B (1.8 min). Postoperative nausea and vomiting were significant (P = 0.004) in ketofol group.

Conclusion: We concluded that ketofol had a better hemodynamic stability compared to propofol as an induction agent, however time for recovery in ketofol group took a longer period compared to propofol group, with no complication in either groups.

Keywords: Hemodynamic stabitlity; ketofol; laproscopic surgeries; postoperative recovery; propofol.