TO STUDY THE DIFFERENCES BETWEEN HAEMODYNAMIC CHANGES SEEN IN TOTAL INTRAVENOUS ANAESTHESIA AMONGST : PROPOFOL–KETAMINE AND PROPOFOL–FENTANYL

Dr Rahul Kumar; Dr K K Khan; Dr Parth Rai; Dr Rohit Tiwari; Dr Anuj Pandey; Dr Brijesh Viroja

Volume : VII, Issue : III, March - 2018

TO STUDY THE DIFFERENCES BETWEEN HAEMODYNAMIC CHANGES SEEN IN TOTAL INTRAVENOUS ANAESTHESIA AMONGST : PROPOFOL–KETAMINE AND PROPOFOL–FENTANYL

Dr Rahul Kumar, Dr K K Khan, Dr Parth Rai, Dr Rohit Tiwari, Dr Anuj Pandey, Dr Brijesh Viroja

Abstract :

INTRODUCTION

This study was conducted to evaluate and compare two drug combinations for TIVA (Total Intravenous Anesthesia) using propofol––ketamine and propofol–fentanyl and to study the induction, maintenance and recovery characteristics of anaesthesia with these techniques.

AIMS AND OBJECTIVES

To find a proper combination of agents for safe total intravenous anesthetic technique, to prevent atmospheric pollution. For this my present objective is to compare Propofol– ketamine combination Vs. Propofol–Fentanyl combination.

MATERIAL AND METHODS

After obtaining approval from institutional ethical committee and written informed consent from the patients this study was carried out of 100 patients of either sex of ASA grade I & II, aged 20–45 years selected elective abdominal surgeries under general anesthesia. Patients were randomly allocated into two group (n = 50 each) depending upon the use of study drugs.

Exclusion criteria:

Patient with suspected difficult airways

History of allergy to study drugs

Patient taking antihypertensive systematic diseases drugs

Patient having significant systematic diseases

Patient in whom laryngoscopy and intubation require>1attempts and or lasted >30 seconds

Plans of study–

Grop K : ketamine as study drugs

Grup F: fentanyl as study drugs

METHOD – Preoperative explanations will be given to the fit patients. Monitoring gadget (ECG, SPO₂ and non invasive BP cuff ) were attached to the patient before anesthetic administration. Pre oxygenation with 100% oxygen was done for 3 mints before induction. Induction of anesthesia was done by propofol 1.5 mg / kg immediately followed by ketamine 0.5 mg/kg in group k or fentanyl (0.2 ug)/kg in group f.

All patients were received inj. succinylcoline 1.5mg/kg and ventilated. Laryngoscopy followed by endotracheal intubation and ventilated. Anesthesia was maintained by propofol ( 100 ug/kg at 10 mint interval in group k / fentanyl (1ug/kg /hour) in group f, vecuronium (0.80 mg/kg ) as bolus followed by 0.03 mg/kg as top ups if required and IPPV.

CONCLUSION

propofol–ketamine and propofol–fentanyl can be used as an excellent combination in TIVA for various elective surgeries where minimal side effects and early recovery are desired. However, due to wider availability and lower cost, we prefer & recommend propofol–ketamine combination .