Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 May;8(5):GC01-4.
doi: 10.7860/JCDR/2014/8144.4393. Epub 2014 May 15.

Comparison of Propofol and Ketamine versus Propofol and Fentanyl for Puerperal Sterilization, A Randomized Clinical Trial

Nalini Kb  1 , Anusha Cherian  2 , Hemavathi Balachander  3 , Yashavantha Kumar C  4
Affiliations

Comparison of Propofol and Ketamine versus Propofol and Fentanyl for Puerperal Sterilization, A Randomized Clinical Trial

Nalini Kb et al. J Clin Diagn Res. 2014 May.

Abstract

Background: Puerperal sterilization requires a rapid recovery of the mother so that she can take care of her child. Propofol with fentanyl (PF) is an option, but is associated with intraoperative hypotension, respiratory depression and an unsatisfactory postoperative recovery profile. Propofol with ketamine (PK) appears to be an alternative in terms of haemodynamic stability and analgesia.

Materials and methods: This randomized clinical trial involved 60 patients who were scheduled to undergo puerperal sterilization, who belonged to American society of anaesthesiologists (ASA) physical status 1. Patients were randomly allocated to receive either ketamine - propofol infusion in a concentration of 8mg/ml each (group PK) or fentanyl 2μg/kg intravenously, followed by an infusion of propofol in a concentration of 8mg/ml (group PF). In both the groups, the infusion was started at 300ml/hr till patient lost consciousness. Subsequently, the rate was set at 1.5ml/kg/hr for group PF and at 0.75ml/kg/hr for group PK. After the initial 10 minutes, the infusion rate was reduced to 1ml/kg/hr for group PF and to 0.5ml/kg/hr for group PK. Blood pressure and saturation were the primary outcomes which were measured.

Results: Patients from group PF recorded a significant drop in the systolic blood pressure from the 5(th) minute, in diastolic pressure from the 10(th) minute and transient oxygen desaturation, as compared to group PK. Patients in group PK had adequate surgical conditions and better recovery profiles in terms of pain and sedation.

Conclusion: The combination of ketamine and propofol is a safe and possibly superior alternative to propofol - fentanyl combination in patients who undergo puerperal sterilization, in terms of haemodynamic stability and respiratory depression.

Keywords: Fentanyl; General anaesthesia; Ketamine; Propofol; Puerperal sterilisation.

PubMed Disclaimer

Figures

[Table/Fig-2]:
[Table/Fig-2]:
Systolic blood pressure over time
[Table/Fig-3]:
[Table/Fig-3]:
Diastolic blood pressure over time
[Table/Fig-6]:
[Table/Fig-6]:
VAS score on movement
[Table/Fig-7]:
[Table/Fig-7]:
VAS score at rest
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Badrinath S, Avramov MN, Shadrick M, Witt TR, Ivankovich AD. The use of a ketamine-propofol combination during monitored anaesthesia care. Anesth Analg. 2000;90(4):858–62. - PubMed
    1. Mayer M, Ochmann O, Doenicke A, Angster R, Suttmann H. The effect of propofol ketamine anaesthesia on hemodynamics and analgesia in comparison with propofol fentanyl. Anaesthetist. 1990;39(12):609–16. - PubMed
    1. Furuya A, Matsukawa T, Ozaki M, Nishiyama T, Kume M, Kumazawa T. Intravenous ketamine attenuates arterial pressure changes during the induction of anaesthesia with propofol. Eur J Anaesthesiol. 2001;18(2):88–92. - PubMed
    1. Hui TW, Short TG, Hong W, Suen T, Gin T, Plummer J. Additive interactions between propofol and ketamine when used for anaesthesia induction in female patients. Anesthesiology. 1995;82(3):641–8. - PubMed
    1. Tomatir E, Atalay H, Gurses E, Erbay H, Bozkurt P. Effects of low dose ketamine before induction on propofol anaesthesia for pediatric magnetic resonance imaging. Paediatr Anaesth. 2004;14(10):845–50. - PubMed

LinkOut - more resources