THE USE OF PROPOFOL VS DIAZEPAM AS CO-ANAESTHETICS FOR KETAMINE/FENTANYL ANAESTHESIA: A COMPARISON OF EFFICACY AT VILA CENTRAL HOSPITAL

Key Words: Ketamine, Propofol, Diazepam, Efficacy, Co-anesthetics, Hemodynamics
Introduction: Diazepam and Propofol have been described as co-anesthetics for ketamine anesthesia to counter its known hemodynamic effects and emergence phenomena. The aim of this study was to compare the clinical efficacy of Propofol vs diazepam as co-anesthetics to ketamine/Fentanyl an aesthesia.
Method: This was a prospective, randomized, single blinded trial comparing Propofol to diazepam as co-an aesthetics to ketamine fentanyl anesthesia for short surgical procedures at Vila Central Hospital operating theatre. 80 ASA I and II patients, aged 1857 were included in the study. Heart rate, blood pressure at 0,3,6,9,12,15 and 20 mins, need for airway and breathing support, emergence scores, dreams and nature of dreams and whether patients were happy to receive the same anesthetic again were recorded perioperatively. All patients received Fentanyl (1 )lglkg) and ketamine(1 mg/kg) and were randomly assigned to receive either Group A-Diazepam(0.1mglkg) or Group Propofol(0.8mglkg).
Results: Group B had a statistically significant lower % change in Systolic (A: 11.15+111.06, B: 3.97+1-13.50, P-value: 0.014) and %change in Mean Arterial Blood Pressure (A:13.48+1-11.63, B:6.39+1-13.90, P-value: 0.017) at 3mins. Other blood pressures were not different. % change in heart rates were statistically lower at 12 minutes in Group B than Group A. Rates of Dreams were higher in group B (A:43.2%, B:71.4%, P-value: 0.0296) however on average the nature of dreams was good in both groups. Emergence scores, need for airway and breathing support, patient satisfaction and time to discharge from recovery were not different between the two groups.
Discussion: Clinically there is no significant difference in hemodynamics and emergence characteristics of the two regimes compared in this study. Need for airway and breathing support though not statistically different, the difference is clinically important(higher in Propofol group). This is a single blinded study looking at low risk patients. Extending this study to higher risk patients, where stable hemodynamics is more indicated would be enlightening.