COMPARATIVE STUDY BETWEEN KETOFOL VERSUS PROPOFOL ANESTHESIA FOR UTERINE CERVICAL DILATION AND CURRETTAGE

Abstract

Background: Ketofol (propofol-ketamine admixture) is used to compensate the hemodynamic chanages due to an induction of anesthesia. Uterine cervical dilation and curettage is a common procedure in day- care surgery. Objective: Comparing the effectiveness of sub-dissociative dose of Ketamine ,in ketofol [group -I]on intraoperative hemodynamic stability, O2%, pain ,anesthesia loading dose- verbal response time , incremental anesthesia ,last dose – verbal response time , surgeon's satisfaction and patient's satisfaction versus propofol alone [group-II]. Patients and method: Two hundred females, ASA I & II scheduled for uterine cervical dilation and curettage, were assigned to I or II groups. Intra-operatively the heart rate, non invasive blood pressure and O2% were monitored and recorded at baseline time, 5th, 10th, 15th and 20th minutes. In recovery room, the pain was assesed by visual analogue scale and the patient's and surgeon's satisfactions were assesed and discharge criteria by Aldrete scoring system and post anesthesia discharge scoring system. Results: The demographic characteristics, the duration of surgical procedure, and anesthesia loading dose - verbal response time showed no statistical difference, but incremental dose - verbal response time was significantly longer in group-I than group-II. Hemodynamic stability statistically had showed no significant differences. The ASS and PDSS were significantly higher in group-II than group-I at 5th but insignificant and equal at 10th minute. Pain was significantly lower in the group-I at 5th and 10th minutes than group-II. Conclusion: The combination of propofol and sub-dissociate dose of Ketamine [Ketofol] was superior to Propofol alone and provided adequate sedation and analgesia for brief painful procedures.