The Induction Dose of Propofol with Ketamine-Propofol and Midazolam- Propofol Co-Induction

Mohsin Nazir Butt

doi:10.4172/2155-6148.1000371

Abstract

Objective: To determine the mean induction dose of propofol with ketamine-propofol and midazolam-propofol co-induction. Methods: A total of sixty patients with American Society of Anaesthesiologist (ASA) physical status I and II, aged 20-50 years, of either sex, undergoing daycare surgeries requiring general anaesthesia were included in this study. The patients were randomly allocated into two equal groups. Group K received ketamine-propofol and group M received midazolam-propofol for induction of anaesthesia. All the patients received pethidine 0.8 mg/kg. Two minutes after the administration of co-induction agent, each patient received 20 mg of lignocaine and injection propofol was given 10 mg every five seconds until patient stopped counting and does not respond to a reminder to continue counting. The level of sedation and alertness was targeted to an observer’s assessment of alertness/ sedation score of 2. Results: Mean induction dose of propofol in the two groups was compared by student’s T test. The mean induction dose was 53.67 (30-120) mg in group K and 52.33 (30-110) mg in group M. The difference between the mean inductions doses of propofol in the two groups were statistically insignificant (P-value of 0.78). Mann Whitney test was also used to compare the mean induction doses of propofol between the two groups. The difference in mean induction doses of propofol was statistically insignificant (P-value of 0.57). Conclusion: There is no difference in the mean induction dose of propofol with ketamine-propofol and midazolam- propofol co-induction.

Highlights

Propofol is a commonly used intravenous (IV) induction agent
Co-induction refers to the administration of a small dose of sedative or other anaesthetic agent prior to the induction of anaesthesia to reduce the dose of induction agent, and to achieve more specific responses while minimizing side effects [3]
In this study we plan to determine if co-induction with a small dose of ketamine is a better option compared to midazolam in reducing induction dose of propofol

Summary

Methods

Approval was taken from institutional ethical review committee (ERC) and written informed consent was taken from each patient. Equal volume of 0.3 mg/kg ketamine and 0.03 mg/kg of midazolam were prepared.The study was double blinded, as the patient and anaesthesiologist responsible for assessing the patients were blinded to the study drugs being used. Total dose of propofol was noted to obtain (OAA/S) score of 2 At this point our study was completed. Using one sided alternatives with type I error 0.05 and power 0.80, assuming a percentage change in mean of 20% and percentage coefficient of variation of 40% in dose of propofol between two groups, the calculated sample size is a total of 60 patients divided into ketamine-propofol and midazolam-propofol groups. All continuous variables i.e. patient’s age, sex, weight, height, body mass index (BMI), and haemodynamic responses i.e. heart rate, arterial oxygen saturation, systolic, diastolic and mean blood pressure and dose of propofol was presented by mean ± standard deviation (SD). Stratification was done with regards to age, gender, BMI and ASA status to see the effect of them on outcome

Results

Introduction

Result

Discussion