Ketamine-propofol sedation versus propofol-pethidine sedation for minor plastic surgery procedures

Hoda Shokri

Ain-Shams Journal of Anaesthesiology 2016 9(2):245-249

Objective The aim of the study was to compare the efficacy of ketamine-propofol (KP) sedation versus propofol-pethidine (PP) sedation for minor plastic surgery procedures. Patients and methods This prospective study was conducted by randomization of 60 patients undergoing minor plastic surgery procedures. Patients were randomly divided into two groups by means of the sealed envelope technique: the KP group (n = 30) and the PP group (n = 30). In the former group, patients received induction with a bolus dose of ketamine 1 mg/kg dissolved in 10 ml saline, and in the latter group patients received induction with a bolus dose of 1 mg/kg pethidine dissolved in 10 ml saline intravenously. In both groups propofol was given as 1 mg/kg propofol, intravenous, bolus dose, additional doses of propofol 30 mg IV were given if sedation score was less than 4 in both groups followed by 5 mg/kg/h intravenous infusion. Sedation score, pain score, mean arterial blood pressure, total dose of propofol, conversion to general anesthesia, postoperative patient satisfaction score, and incidence of postoperative complications such as hypotension, oxygen desaturation, and vomiting were all recorded. Results Intraoperative pain scores, mean arterial blood pressure, and postoperative patient satisfaction scores were significantly higher in the PP group compared with the KP group. The sedation score was significantly higher in the KP group than in the PP group. Total dose of propofol was significantly lower in the KP group than in the PP group. There was no significant difference between the study groups regarding conversion to general anesthesia. Recovery time was significantly longer in the KP group compared with the PP group. There were significant differences in the incidence of complications such as oxygen desaturation and postoperative vomiting among the study groups. Conclusion The KP combination provides an attractive combination for procedural sedation compared with PP combination in terms of better sedation, hemodynamic stability, and lower incidence of complications.

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