Propofol-ketamine versus propofol-fentanyl for outpatient laparoscopy : Comparison of postoperative nausea, emesis, analgesia, and recovery

Abstract

Study objective To compare postoperative nausea, emesis, analgesia, and recovery between propofol-ketamine and propofol-fentanyl in outpatient laparoscopic tubal ligations with general anesthesia. Study design Prospective, randomized, blinded study. Setting Tertiary-care women’s hospital. Patients 120 ASA physical status I and II ambulatory patients scheduled for elective laparoscopic tubal ligation. Interventions Patients were randomized to two groups to receive either ketamine (1-1.5 mg/kg) or fentanyl (3-5 μg/kg). Measurements Measured variables included total dose of ketamine, fentanyl, propofol, and operating time. Vital signs, pain visual analog scale scores (VAS), nausea VAS, presence of emesis, treatment for nausea and vomiting, pruritus, sedation, and presence of dreaming were recorded on postanesthesia care unit (PACU) admission, PACU discharge, stepdown unit admission, and hospital discharge. Results are expressed as means ± SD or medians and analyzed using t -test, Chi-square, or Mann-Whitney (p < 0.05). Main results No differences were noted with respect to propofol dose, operating times, pain or nausea VAS scores, emesis, treatment for nausea and vomiting, pruritus, and sedation on PACU admission, PACU discharge, stepdown unit admission, and hospital discharge. The ketamine group had a higher heart rate, required more pain medication, and had a higher frequency of dreaming on PACU admission than the fentanyl group. These differences became insignificant on PACU discharge. Conclusions For outpatient laparoscopic tubal ligations with general anesthesia, propofol-ketamine does not improve postoperative nausea, emesis, analgesia or recovery compared with the propofol-fentanyl combination.