A Prospective Evaluation of Different Ketofol Concentrations for Sedation and Analgesia in Catarct Surgery Performed Under Local Anesthesia, AHMED M.M. ROSHDY, GEHAN F. KAMEL, GEHAN A. GOMAA and KEROLOS E. MORIS
Abstract
Background: Ketofol is a mixture of ketamine and propo-fol. It is one of the agents known to achieve procedural sedation and analgesia. Aim of Study: This prospective randomized study compared the effectiveness and safety of four doses of ketofol for sedation and analgesia in catarct surgery performed under local anesthesia. Patients and Methods: 80 adult patients aged between 40-65 years of both sexes, scheduled for cataract extraction and intraocular lens implantation, were enrolled in this, interventional study. They were divided into 4 groups of 20 patients each. Results: In the present study as regards to haemodynamics (HR & MAP), we found most patients developed modest increases in pulse rate and blood pressure in all groups but the higher increase was found in groups I & II compared to III & IV. As regards to mean oxygen saturation and respiratory rate in the current study there was lower mean oxygen satu-ration in groups III and IV after 5 minutes of drug infusion (T1) compared to the other groups. However, the difference is not statistically significant (p-value >0.05). Mean IOP after sedation was significantly higher among groups I & II com-pared to groups III & IV (p-value <0.05) which is related to the ketamine high doses. Conclusion: This current study suggests that Ketofol (ketamine/propofol concentration) at a ratio 3:1 and 4:1 may provide effective and safe sedation for patients undergoing ophthalmic procedures under regional anesthesia. An intrave-nous infusion of a 4:1 ratio is a suitable alternative for delivering ketofol, this provides more stability and consistency of sedation depth and less need for top-up doses that may lead to overshoot of sedation and a delayed recovery.