Evaluation of Different Concentrations of Ketofol as a Sedative in Mastoid Exploration Performed under Local Anaesthesia

Author(s): Sumitra Kanojiya1 , Vibha Mehta2 , Mahender Singh3 , Geetika Duggal4 , Ruhani Arora5 , Sunil Sorout6

BACKGROUND Ketofol analgesia is considered a safe and useful technique as an alternative to general anaesthesia. The present study aimed to evaluate the use of “ketofol” as sedative in mastoid exploration performed under local anaesthesia. METHODS 100 ASA grade I and II physical status patients aged 15 to 60 years were divided in to four equal groups of 25 patients each. Group I – Propofol / ketamine (2:1) infusion @ 2.5 mg / Kg / hr.; Group II – Propofol / ketamine (2:1) infusion @ 1.5 mg / Kg / hr.; Group III – Propofol / ketamine (3:1) infusion @ 2.5 mg / Kg / hr.; Group IV – Propofol / ketamine (3:1) infusion @ 1.5 mg / Kg / hr. RESULTS There was significant decrease in BP from baseline in all groups after induction. Significant hypotension was noted in one patient of group 3 (4 %) which was corrected by IV RL infusion (10 mg / kg). Difference between group III and others was insignificant. All patients had decrease in HR from baseline, maximum decrease in group II (p<0.05) but no patient had severe bradycardia requiring any intervention. After induction, all groups displayed marginal increase in ETCO2, RR and SPO2, all changes from baseline were statistically insignificant. None of the patients had hypoxia / excessive salivation. CONCLUSIONS Propofol in a concentration of 3:1 @ 2.5 mg / Kg / hr. provides titrable and predictable sedation with least consumption of propofol and ketamine and had minimum adverse effects.