Comparison of ketamine and fentanyl with propofol in total intravenous anesthesia: a double blind randomized clinical trial

Abstract

Background: Propofol has emerged as a gold-standard for total inrtravenous anesthesia (TIVA) for short surgical interventions but lack of analgesia remains it’s main shortcoming therefore it is always combined with an analgesic. Ketamine and fentanyl are the popular analgesic in this context. This study was carried out to compare these drugs with propofol to assess hemodynamic and recovery profile of either combination.Methods: Hundred consenting patients undergoing short elective surgeries were randomly allocated into two groups of fifty each: group PF received propofol 2 mg/kg + fentanyl 2 μg/kg for induction and propofol 4 mg/kg/hr + fentanyl 1μg/kg/hr for maintenance of anesthesia and group PK received propofol 2mg/kg + ketamine 1mg/kg for induction and propofol 4mg/kg/hr + ketamine 1 mg/kg/hr for maintenance of anesthesia. Hemodynamic variables were recorded pre, intra and postoperatively at regular intervals. At the end of drug infusion(s), time to spontaneous eye opening and response to postoperative questionnaire was noted to assess recovery. All the data presented as mean + standard deviation and number of patients. Results: Patients in both did not differ significantly in demographic and hemodynamic profile. Time to spontaneous eye opening was similarly comparable in both the groups (8±3 min and 8±2 min) (p=0.53). Response to postoperative questionnaire at 30 minutes after anesthesia was good in both the groups. Incidence of postoperative nausea and vomiting was also insignificant statistically between both the groups. (p=0.74)Conclusion: We concluded that both ketamine and fentanyl are equally safe and efficacious with propofol for short surgical procedures.