بررسي اثرات تركيب پروپوفل - كتامين و پروپوفل - فنتانيل در جراحي هاي سرپايي

A COMPARISION OF PROPOFOL - KETAMINE COMBINATION WITH PROPOFOL - FENTANYL IN OUTPATIENT SURGERY

Background & Aim : General anesthesia remains the most widely used anesthetic technique for managing ambulatoy surgery. The ability to deliver a safe and cost effective general anesthetic with minimal side effects and rapid recovery is critical in outpatient surgery unit. Questions regarding the optimal anesthetic technique, remain to be answered. This study was designed to compare the difference between the effects of propofolketamine and propofol fentanyl total intravenous anesthesia (TWA); on hemodyamic, respiratory and recovery profiles. Materials & Methods : Sixty patients, ASA class I-II undergoing outpatient surgery were randomly assigned to one of two groups (n=30 each). After premedication with midazolam (0102 mg/kg), the first group recieved I µg/kg fentanyl followed by 1 mg/kg propofol; while 0/3 mg/kg ketamin replaced fentanyl in the second group. Anesthesia was maintained with propofol infusion (50µg/kg/min) in both groups, Results : Incidence of hypotension (k:3/3%, F: 70%), bradycardia (K-4/3%, F:43/3%) and mean apnea duration (k:37/7 s, F: 184/5s) was significantly lower in the ketamine-propofol group. (p<0.0001).Recovery time was simillar in two groups. Psychomimetic side effect was not seen in each of the groups. Discussion : TWA with ketamine (as analgesic with subhypnotic dose) and propofol is comparable to the most commonly used combination of propofol fentanyl,and may be an appropriate choice when hemodynamic stability is of great importance.