Comparison of hemodynamic changes in ketamine versus fentanyl as co-induction agent with propofol in elective surgical procedures

Abstract

Objectives: To assess the hemodynamic changes caused by the co-induction of ketamine or fentanyl with propofol.

Methodology: This prospective randomized trial included 220 patients that underwent elective surgical procedures under general anesthesia with endotracheal intubation. Random allocation of patients was done into two equal groups and drugs were administered using the double-blinded technique. Group A received propofol and fentanyl while group B received propofol and ketamine given as intravenous bolus doses. Measurement of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) was done before induction and 10 minutes after induction before the surgical stimulus. Independent samples t-test and paired t-test were employed for analysis of the collected data.

Results: Both groups had normal hemodynamic parameters before induction; however, there was a significant difference in hemodynamic indices of both groups after 10 minutes of induction (p<0.001). Group A showed a significant decrease in SBP, DBP, and MAP after 10 minutes of induction (p<0.001). The patients in group B showed a significant increase in mean HR from baseline to 10 minutes (p<0.001). Group B demonstrated no change in the systolic, diastolic, and mean arterial pressures; however, group A elucidated a significant decrease in these hemodynamic parameters.

Conclusion: The combination of ketamine and propofol provides better hemodynamic stability than fentanyl and propofol. More studies are required to evaluate these changes in patients with cardiovascular comorbidities.