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Indian Journal of Anesthesia and Analgesia

Volume  7, Issue 2, Mar-Apr 2020, Pages 613-620
 

Original Article

Efficacy of Propofol-ketamine Over Propofol-butorphanol in Surgical Procedures less than 60 Minutes

Md Ayathullah, P Sahithya, Pujala Umapathy

1Associate Professor, 2Junior Resident, 3Assistant Professor, Department of Anesthesiology, SVS Medical College, Mahbubnagar, Telangana 509001, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7220.25

Abstract

Context: Propofol due to its favorable pharmacokinetic profile is widely used in TIVA. Propofol, when used alone causes decrease in cardiac index and mean arterial pressure and lacks analgesic property. To
overcome these disadvantages, many adjuvant drugs are added. Aim: To compare two drug regimens: Propofol-ketamine and propofol-butorphanol in surgical procedures less than 60 minutes. Settings and Design: Hospital based comparative study was carried out at Department of Anesthesiology, SVS Medical College, Mahabubnagar. Methods: Sixty patients aged 18–60 years of both sexes belonging to ASA I and ASA II Grades were randomly allotted to one of two groups of 30 each. Group K received ketamine 1 mg/kg and propofol
1.5 mg/kg as inducing agent and Group B received butorphanol 20 μg/kg and propofol 1.5 mg/kg. In both the groups, anesthesia was maintained with propofol 9 mg/kg/hr via infusion pump. Heart rate, SBP, DBP were monitored as baseline, induction and in postinduction period after 10, 20, 30, 40 minutes. Occurrence of pain on injection with propofol was noted. Postoperative sedation was assessed using Ramsay Hunt sedation score and incidence of PONV was noted in both groups. Statistical Analysis: The data was analyzed using t-test and p - value of < 0.05 was considered statistically significant. Results: In Group B, there was significant variation in heart rate, SBP and DBP at everytime interval from baseline to end of surgery whereas there was
no statistically significant change in hemodynamic parameter throughout surgery in Group K. The incidence of sedation postoperatively in Group K was 36.7% whereas in group B it was 46.7%. It was found that in
Group B patients 23.3% of them had pain as compared with 56.7% in Group K showing pain. There was no statistically significant difference in two groups regarding incidence of PONV. Conclusion: Data and their
analysis suggest that combination of Propofol-ketamine, offered better hemodynamic stability over propofolbutorphanol.


Keywords : Anesthesia technique; TIVA; Hemodynamic stability; PONV; Propofol; Ketamine; Butorphanol.
Corresponding Author : Pujala Umapathy