EFFECT OF TWO DRUG COMBINATIONS PROPOFOL-KETAMINE AND PROPOFOL-FENTANYL ON HEMODYNAMIC PARAMETERS AND RECOVERY FROM ANAESTHESIA IN TIVA-A COMPARATIVE STUDY

Abstract

Introduction- Total Intravenous anaesthesia(TIVA) is widely used procedure. We compared the effect of propofol-ketamine combination with propofol-fentanyl combination on hemodynamic parameters and recovery of patients undergoing TIVA. T Aims and Objective- o compare the effect of combination of propofol and ketamine and combination of propofol and fentanyl for TIVA, on hemodynamic parameters and recovery from anaesthesia. Patients aged 20- to 60-year-old, ASA-PS I and II, undergoing elect Material and Method- ive surgeries were selected for the study and were divided into two groups (1 and 2) of 90 each. TIVA was administered in the two groups as- Group-1 Induction- Propofol 1.0mg/kg+Ketamine 1.0mg/kg, iv boluses. Maintenance- Propofol 2.0 mg/kg/h and Ketamine 2.0 mg/kg/h, iv infusion. Group-2 InductionPropofol 1.0mg/kg+Fentanyl 2.0µg/kg, iv boluses. Maintenance- Propofol 2.0mg/kg/h and Ketamine 2.0µg/kg/h, iv infusion. All the patients were mechanically ventilated with 100% oxygen. Neuromuscular blockade achieved with Vecuronium-bromide. Vital-parameters were recorded at regular intervals and DJ Steward recovery score was calculated. Following i Result- nduction, heart rate (HR) increased in Group-1 and decreased in Group-2 and mean blood pressure (systolic and diastolic) increased in Group-1 while it decreased in Group-2. HR and blood pressure(BP) returned towards baseline during maintenance in both the groups. HR and BP increased in both the groups following extubation but gradually returned to baseline. Group-1 scored higher on ventilation, whereas Group-2 scored higher on wakefulness and movement. Though the difference became insignicant post 10 minutes. Both propofol-ketamine and propofol-fentanyl combinations Summary- can be utilized in TIVA for short elective procedures because they offer effective surgical anaesthesia with little strain on hemodynamic parameters, which helps to preserve stability and speed up recovery