Patient satisfaction with low-dose ketamine versus lornoxicam in conjunction with propofol in outpatient hysteroscopy

Abstract

Purpose The aim of this study was to compare the effect of adding low-dose ketamine or lornoxicam to propofol in outpatients undergoing hysteroscopy with respect to patient and doctor satisfaction, recovery and discharge time, and intraoperative and postoperative adverse effects. Methods This is a double-blind prospective study on 60 ASA I and II patients undergoing outpatient operative hysteroscopy. They were divided randomly into two equal groups: group KP and group LK. Patients in group KP received 0.25 mg/kg ketamine followed by 2% propofol boluses of 20 mg/ml until a bispectral index (BIS) of 70 was achieved; patients in group LK received 8 mg lornoxicam followed by the same propofol boluses until the same sedation level was achieved. Incremental boluses of 1–2 ml of propofol were given all through the procedure to achieve BIS 70. Time to reach BIS 70, total dose of propofol given, recovery and discharge time, patient and doctor satisfaction, and intraoperative and postoperative adverse effects were all assessed. Results Time to reach BIS 70 was statistically shorter in the ketamine–propofol group (2.1±1.1 min) than in the lornoxicam–propofol group (3.7±1 min). The total dose of propofol was statistically higher in the lornoxicam–propofol (197±15.8 mg) group than in the ketamine–propofol group (176.2±16 mg). Recovery time and discharge time were significantly shorter in the lornoxicam–propofol group than in the ketamine–propofol group. Patient and doctor satisfaction scores were significantly higher in the ketamine–propofol group than in the lornoxicam–propofol group. Postoperative hallucination and agitation were statistically higher in the ketamine–propofol (16.6%) group than in the lornoxicam–propofol group. Conclusion Addition of 0.25 mg/kg ketamine to propofol is a reliable method for providing satisfactory sedation and analgesia in patients undergoing outpatient hysteroscopy in comparison with lornoxicam–propofol.