Comparison of propofol and ketamine propofol mixture ketofol on laryngeal tube suction II conditions and hemodynamics a randomized prospective double blind trial

Abstract

Objective: The aim of our study is to compare the effect of ketamine–propofol mixture (ketofol) and propofol on the laryngeal tube-Suction II (LTS II) insertion conditions and hemodynamics. Methods: Eighty American Society of Anesthesiologists class 1 and 2 patients were divided into 2 random groups to receive either 1 mg/kg remifentanil and propofol 2 mg/kg in Group P (n ¼ 40), or 1 mg/kg remifentanil and ketofol (using a 1:1 single syringe mixture of 5 mg/mL ketamine and 5 mg/mL propofol) in Group K (n ¼ 40) before induction of anesthesia. After induction, LTS II was inserted. Heart rate and noninvasive blood pressure were recorded before induction of anesthesia (t0); immediately following induction (t1); immediately after LTS II insertion (t2); and 3 minutes (t3), 5 minutes (t4), and 10 (t5) minutes after LTS II insertion. Conditions of insertion of LTS II were assessed and scored 1 to 3 using 6 variables as follows: mouth opening, swallowing, coughing, head and body movements, laryngospasm, and ease of LTS II insertion by the same experienced anesthesiologist who did not know the agents. LTS II insertion summed score was prepared depending upon these variables. Results: In regard to LTS II insertion summed score, Group K was more favorable than Group P (P o 0.05). Apnea duration was longer in Group P (385.0 seconds [range ¼ 195.0–840.0 seconds]) compared with Group K (325.50 seconds [range ¼ 60.0–840.0 seconds]) but this was not statically significant. The heart rate values were significantly lower at all measurement intervals in both groups compared with the baseline values (P o 0.05). There was no difference in heart rate between Group P and Group K. The mean arterial pressure values were significantly lower at all measurement intervals in Group P compared with baseline values (P o 0.05). In Group K, the mean arterial pressure values were significantly lower at all measurement intervals compared with the baseline values, except t2 (P o 0.05). There was a significant difference between Group P and Group K in terms of mean arterial pressure at t3 (P o 0.05). Conclusions: We found that ketofol provided better insertion summed score for LTS II than propofol, with minimal hemodynamic changes.