A Comparative Study of Ketamine-Propofol versus Fentanyl-Propofol in Total Intravenous Anaesthesia- A Double Blind Randomised Clinical Trial

BACKGROUND Propofol has emerged as a gold-standard for total intravenous anaesthesia (TIVA) for short surgical interventions but lack of analgesia remains its main shortcoming, therefore it is always combined with an analgesic. Ketamine and fentanyl are the popular analgesic in this context. This study was carried out to compare these drugs with propofol to assess haemodynamic and recovery profile of either combination OBJECTIVE - To evaluate quality and compare haemodynamic variability of anaesthesia among the patients scheduled for short surgical procedures in ketamine-propofol and fentanyl-propofol groups. MATERIALS AND METHODS In this study, 60 consenting patients undergoing short elective surgeries were divided into two groups of fifty each. Group PF received propofol 2.5 mg/kg + fentanyl 1 g/kg for induction and propofol 2 mg/kg/hr. + fentanyl 0.5 g/kg/hr for maintenance of anaesthesia and group PK received propofol 2.5 mg/kg + ketamine 1 mg/kg for induction and propofol 2 mg/kg/hr. + ketamine 1 mg/kg/hr. for maintenance of anaesthesia. Haemodynamic variables were recorded pre, intra and postoperatively at regular intervals. At the end of drug infusion (s), time to spontaneous eye opening and response to postoperative questionnaire was noted to assess recovery. All the data presented as mean + standard deviation. RESULTS Patients in both groups did not differ significantly in demographic profile and haemodynamic parameters. Time to spontaneous eye opening was similarly comparable in both the groups (8 3 min. and 8 2 min. ) (p = 0.53). Response to postoperative questionnaire at 30 minutes after anaesthesia was good in both the groups. Incidence of postoperative nausea and vomiting was also statistically insignificant between both the groups. (p = 0.74). CONCLUSION Ketamine and fentanyl with propofol infusion for short surgical procedures are equally safe and efficacious. In both groups stable haemodynamics and good recovery profile were noted.