A Comparative Study on the Effects of Ketofol, Dexmedetomidine, and Isofol in Anesthesia of Candidates for Dilatation and Curettage

Abstract

Background: Dilatation and curettage (D & C) is one of the relatively common surgeries among women. Familiarity with the analgesics, along with their different uses and specific characteristics, can help to determine the best and most appropriate drug to control pain in the patients. Objectives: This study aimed to compare the effects of ketofol, dexmedetomidine, and isofol in anesthesia of candidates for D & C. Methods: In this double-blind clinical trial, 150 candidates for D & C surgeries with ASA class 1 and 2 were included. Patients were randomly divided into three groups. The first group received ketamine + propofol, the second group received dexmedetomidine, and the third group received isofol (isoflurane + propofol). Any hemodynamic changes or respiratory disorders, including apnea or hypoventilation, drop in the level of blood oxygen saturation, and the need for respiratory support, were recorded and compared. Results: Hypoventilation was observed in 47 patients in isofol group, 18 in the dexmedetomidine group, and 42 in ketofol group. Also, 48 patients in the isofol group, eight in the dexmedetomidine group, and 33 in the ketofol group experienced apnea. Moreover, 17 patients in the dexmedetomidine group, 35 in the ketofol group, and eight in the isofol group experienced bradycardia. The rate of bradycardia was significantly higher in the dexmedetomidine group (70%) compared to the other two groups, and the rate of hypotension was significantly higher in the isofol group (P = 0.001). Conclusions: According to the results, dexmedetomidine was associated with fewer complications during general anesthesia in D & C surgery.

Comparison of the Effect of Adding Low-dose Ketamine to Dexmedetomidine and Propofol on the Quality of Sedation and Hemodynamic Response in Children During Upper Gastrointestinal Endoscopy: A Double-blind Randomized Clinical Trial

“…Furthermore, dexmedetomidine can effectively and safely reduce not only the hemodynamic blood pressure reaction caused by ketamine but also the psychological effects of ketamine (19). In fact, dexmedetomidine is expected to prevent tachycardia, high blood pressure, sialorrhea, and the emergence phenomenon associated with ketamine.…”

“…From the mentioned population, 52 patients were selected as the sample using the convenience random sampling method considering the confidence level of 95%, the test power of 80%, the SD of the sedation rate after endoscopy in previous studies (19) to be equal to 1, and the minimum significant difference between the 2 groups to be equal to 0.8.…”

“…Dexmedetomidine is also a selective α-2 agonist with sedative and analgesic properties, and its most important advantage is that it does not cause respiratory depression (18). Therefore, today, its premedication is increasing (19,20).…”

“…In this regard, the results of some recent reports have indicated that the combination of sedative medicines such as propofol, dexmedetomidine, and ketamine can neutralize the adverse effects of each other and create the best and most effective sedation with the least adverse effects for the patient by prescribing the minimum dose of these medicines (11,19,(21)(22)(23)(24).…”