Comparison of Ketamine versus Fentanyl as an adjuvant with Propofol for inserting Laryngeal Mask Airway

Materials and Methods: 120 adult, ASA 1 and 2 patients were randomly allocated into two groups, propofol-ketamine (PK) and propofol-fentanyl (PF), (n=60 in each group) Baseline parameters- oxygen saturation (SpO2), Mean Blood Pressure (BP), Pulse Rate (PR) and End Tidal carbon dioxide (EtCO2), were recorded following which 1µg/ kg Fentanyl to the PF group & 0.5 mg/kg Ketamine to the PK group was given intravenously. Induction was initiated with infusion of 1% Propofol @ 1mg/ kg/ min with a syringe pump to avoid apnea. Tolerance to jaw thrust was regarded as end point for LMA insertion. Statistical analysis done by Parametric and non parametric values were analyzed using student's unpaired t-test and Mann Whitney's U test respectively. Intragroup differences analyzed by one-way ANOVA with significance using Tukey's method. The incidence of apnea was analyzed using Chi- square test. P<0.05 was considered significant. Results: There was a significant(P<0.05) fall in heart rate, the systolic, diastolic & mean arterial pressures, from baseline to LMA insertion in the propofol-fentanyl group when compared to propofol-ketamine group. No significant difference in the insertion conditions was noted between the two groups. None of the patients in either of the two groups had any significant adverse events. Conclusion: we conclude that propofol-ketamine preserves hemodynamic and ventilatory stability compared to propofol-fentanyl, while providing similar LMA insertion conditions. Key Message: Infused Propofol - ketamine combination can be a better alternative to Infused propofol fentanyl for induction and insertion of LMA in selected group of patients where maintenance of blood pressure and ventilation are utmost important during induction.