Abstract
Background: Induction of anesthesia with propofol is known to produce systemic hypotension. Co-induction adds a small dose of other anesthetics to reduce the dose of induction agent to decrease hemodynamic disturbances. The aim of the study was to compare hemodynamic changes associated with Midazolam and ketamine as a coinduction agent with Propofol and to compare induction dose of Propofol following the co-induction.Methods: Fifty adult patients undergoing elective surgery to be performed under general anesthesia were randomized to receive 0.3 mg/kg of Ketamine or 0.03 mg/ kg of Midazolam intravenously as co-induction agent. A minute after administration of co-induction agent, anesthesia was induced with Propofol 40 mg bolus then 10 mg every 10 seconds until the loss of verbal response. The hemodynamic response at 0, 1, 2, 5 minutes respectively and the induction dose of Propofol were noted.Results: The mean arterial pressure heart rates were significantly lower at 1, 2 and 5 minutes in midazolam group. However, mean arterial pressure and heart were within the physiological range in both the groups. Propofol dose requirement for induction between the two groups was similar (p>0.05) but co-induction significantly decreased the induction dose of Propofol as compared to standard recommended dose for induction.Conclusion: Our study showed that hemodynamic variables were maintained within the physiological range with midazolam and ketamine co-induction. However, lesser degree of decrease in mean arterial pressure was seen with ketamine but the heart rate was higher. A similar reduction of induction dose of propofol was achieved with both the drugs.Journal of Society of Anesthesiologists of Nepal 2015; 2(2): 62-66
Highlights
The term co-induction has been used to describe the practice of administrating a small dose of sedative or other anesthetic agents to reduce the dose of induction agent.[1]
We aimed to study whether adding a small dose of midazolam or ketamine would give better blood pressure and heart rate control or not
Our study showed that there was a significant decrease in blood pressure and heart rate in the midazolam group but it remained within the physiological range
Summary
The term co-induction has been used to describe the practice of administrating a small dose of sedative or other anesthetic agents to reduce the dose of induction agent.[1]. The induction dose of Propofol is 1.5 to 2.5 mg/ kg intravenous with blood level of 2 to 6 mg/ml. It depends on the associated medications and the patient's age.[2] It produces the decrease in systemic blood pressure with bradycardia or no change in heart rate.[3]. Co-induction adds a small dose of other anesthetics to reduce the dose of induction agent to decrease hemodynamic disturbances. The aim of the study was to compare hemodynamic changes associated with Midazolam and ketamine as a coinduction agent with Propofol and to compare induction dose of Propofol following the co-induction
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