Recovery Time and Time of First Request for Postoperative Analgesia in Day-case Surgery: Propofol-Ketamine Vs Propofol-Fentanyl

Abstract

Background: The significance of recovery time and adequate postoperative analgesia for day case surgery has led to various trials of drug combinations in other to get the benefit of both early recovery with prolonged postoperative analgesia. Various intravenous analgesic agents in combination with propofol has been tried in an attempt at finding the ideal drug combination for short surgical procedures. Objectives: This study compared the recovery time and time of first request for postoperative analgesia of two drug combinations: propofol-ketamine and propofol-fentanyl used as the sole anaesthetic agents for short surgical procedures in adult’s day case surgery. Methods: One hundred and eight adults aged 18 to 50 years of either gender with ASA physical status I or II scheduled for elective short surgical procedures were randomly allocated into group K and F, comprising of 54 patients each. Group K received propofol-ketamine while group F received propofol-fentanyl for induction and maintenance of anaesthesia. Vital signs were recorded at the time of induction, maintenance and recovery. Recovery time was assessed using Steward Recovery Score. Postoperative analgesic requirement was assessed based on pain score using the Verbal Rating Scale. Results: Demographic and clinical characteristics such as age, sex, weight, duration of surgery and types of surgical procedures used were comparable between the two groups. Recovery time was
prolonged in group K compared to group F (p=0.01). Time for first request of postoperative analgesia was found to be significantly shorter in group F (p=0.01). Conclusion: Both propofol-ketamine and propofol-fentanyl combinations produced effective postoperative analgesia and appreciable recovery time for daycase surgery. While Propofol-fentanyl has a shorter recovery time, Propofolketamine has a longer period of postoperative analgesia.