Respiratory effects of propofol-ketamine and propofl-fentanyl combinations for total intravenous anaesthesia

Abstract

propofol combined with other intravenous analgesic agents has been used as the sole anaesthetic agent to provide hypnosis and analgesia for various minor and major surgeries.
However, because it lacks analgesic property, propofol in large doses causes respiratory depression. Combination of propofol with other analgesic agents reduces the dose of propofol
necessary for procedural sedation. Objectives: This study evaluated the respiratory effects of two drug combinations: propofol-ketamine and propofol-fentanyl used as the sole anaesthetic agents. Method: one hundred and eight adults aged 18 to 50 years of either gender with ASA physical status I & II, randomly grouped into 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. Respiratory Rate (RR) and Oxygen saturation (SpO were recorded before and one 2) minutes after induction of anaesthesia and thereafter every five minutes till the end of procedure and at recovery till the patient is fully recovered. Results: Demographic and clinical characteristics such as age, sex, weight, duration of surgery, types of surgical procedures and volumes of drugs used were comparable between the two groups. Fall in respiratory rate was greater in propofol-fentanyl group compared to propofol-ketamine group during maintenance and early postoperative period (p<0.05). Conclusion: Both propofol-ketamine and propofolfentanyl combinations produced safe and effective anaesthesia. Propofol-ketamine results in a more stable respiratory profile.