Ketamine- Propofol or Fentanyl- Propofol intravenous infusion a better combination for short surgical procedures in paediatric patients, a comparative study

Introduction: Paediatric patients usually present with various painful conditions that require immediate surgical interventions. Many studies have been done on ketamine propofol combination to prove its efficacy. Aim: The aim was to compare the effect of propofol-ketamine and propofol-fentanyl infusion in terms of haemodynamic stability, postoperative sedation, postoperative nausea and vomiting and adverse effects if any. Materials and Methods: This was a prospective, randomized, double blind controlled trial conducted in 60 patients of ASA Grade I & II of age group 3 to 14 years. Patients were randomly allocated into two groups to receive either ketamine 1mg/kg before induction (group PK, n=30) or fentanyl 1.5 ug/ kg before induction (group PF, n=30) and patients in both groups were induced with propofol 2 mg kg and maintained on propofol infusion at rate of 50 ug/ kg /min. Heart rate and blood pressure were monitored throughout the procedure. Sedation was monitored by Ramsay sedation score and side effects were noted. Results: In PF group there was a fall in heart rate as compared to PK group. There was a statistically significant fall in systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) in PF group (P 0.05). In PK group there is no significant fall in SBP, DBP and MAP. The patients in group PF were more sedated postoperatively and there was increased incidence of postoperative nausea and vomiting in group PF as compared to group PK. Conclusion: Propofol-ketamine combination is better as compared to propofol-fentanyl in terms of haemodynamic stability and better recovery with less side effects.