Co-induction effects of midazolam, thiopentone and ketamine with propofol in general anesthesia

Rajkumar, Gojendra; Thokchom, Rupendra Singh; Pradhan, P.; Singh, Mahendra; Singh, Huidrom Lokhendro; Singh, Ratan N

doi:10.4103/0972-4958.121578

Cited by 6 publications

(5 citation statements)

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“…11 The difference between the groups was significant. Likewise, similar findings in studies by Srivastava et al, Rajkumar et al, Sukhminder Jit Singh Bajwa et al and Ramdev et al 10,12,13,15 Ketamine with Propofol is an NMDA receptor antagonist and Propofol acts on GABA receptor. Although both the agents act in different receptors, reduction in the Propofol dose along with ketamine is due to the additive sedation effect of both the drugs.…”

Section: Discussionsupporting

confidence: 78%

Anesthetic Properties of Propofol and Ketofol (Ketamine With Propofol): A Comparative Study

Yadav¹,

Thapa²,

Sah³

et al. 2022

JCMC

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Background: Surgical procedures require a safe anesthesia and safe anesthetic agents for this purpose use of small dose of sedative agent or any other anesthetic agent in order to reduce the dose requirement as well as adverse effects of the main inducing agent. Therefore, this study was carried out using ketamine with propofol (KETOFOL) to compare the hemodynamic stability (Heart rate and Mean arterial pressure) and induction doses. Methods: Fifty patients of age 18 to 60 years of ASA II and I scheduled for elective surgery to be performed under general anaesthesia were randomly selected and divided into two groups. Patient in Group-P received 50 mg propofol and Group-K received 50 mg (25mg ketamine with 25 mg propofol) intravenously bolus slowly and then 10 mg in every 10 seconds until the loss of eyelash reflex and verbal response. The hemodynamic response was noted at different given time. Chi square test and student’s t test were used for analysis. Results: The study showed that the hemodynamic (heart rate and mean arterial pressure) was maintained and decrease in dose requirement for propofol for induction in (ketamine with propofol Ketofol group whereas there was significant decrease in hemodynamic (heart rate and mean arterial pressure) in Propofol group. Conclusions: Our study concluded that fluctuations in heart rate and mean arterial pressure from baseline were more in propofol group compared to ketofol (ketamine with propofol) group. Therefore, Ketofol achieved better hemodynamic stability over propofol alone and also induction dose of propofol was reduced.

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Section: Discussionsupporting

confidence: 78%

Anesthetic Properties of Propofol and Ketofol (Ketamine With Propofol): A Comparative Study

Yadav¹,

Thapa²,

Sah³

et al. 2022

JCMC

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“…Mandal et al 20 reported that to date, no intravenous induction agent can provide all components of balanced anaesthesia with an acceptable margin of safety and ease of titration and that concomitant administration of adjuvant drugs such as benzodiazepines, opioids or alpha 2 agonists reduces the dose requirement of the primary induction agent. Rajkumar et al 21 found that ketamine reduced the induction dose of propofol more effectively than other induction agents. In our study, we think that the lower requirement for additional doses in Group DK and Group MK is because of the synergism effect of the co‐induction of ketamine and propofol.…”

Section: Discussionmentioning

confidence: 99%

“…opioids or alpha 2 agonists reduces the dose requirement of the primary induction agent. Rajkumar et al 21 found that ketamine reduced the induction dose of propofol more effectively than other induction agents. In our study, we think that the lower requirement for additional doses in Group DK and Group MK is because of the synergism effect of the co-induction of ketamine and propofol.…”

Section: Discussionmentioning

confidence: 99%

The frequency of emergence delirium in children undergoing outpatient anaesthesia for magnetic resonance imaging

et al. 2021

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Aim:The aim of this study was to investigate the effect on the occurrence of emergence delirium of propofol and ketofol with intranasal dexmedetomidine and midazolam applied as premedication to paediatric patients during magnetic resonance imaging (MRI). Methods:The study included children aged 2-10 years who received sedation for MRI, separated into four groups. Group MP (midazolam-propofol) received intranasal midazolam (0.2 mg/kg) for premedication and intravenous (IV) propofol (1 mg/ kg) as the anaesthetic agent. Group MK (midazolam-ketofol) received intranasal midazolam (0.2 mg/kg) for premedication and IV ketofol (1 mg/kg) as the anaesthetic agent. Group DP (dexmedetomidine-propofol) received intranasal dexmedetomidine (1 mcg/kg) for premedication and IV propofol (1 mg/kg) as the anaesthetic agent.Group DK (dexmedetomidine-ketofol) received intranasal dexmedetomidine (1 mcg/kg) for premedication and IV ketofol (1 mg/kg) as the anaesthetic agent. The Paediatric Anaesthesia Emergence Delirium (PAED) scale was used to evaluate delirium. A PAED score ≥ 10 was accepted as delirium.Results: Statistical analysis was made of 140 paediatric patients. Delirium developed in 1.42% of all the patients, and in 5.7% of Group MP. The mean Aldrete and PAED scores were lower and the length of stay in the recovery room was shorter in Group DP than in the other groups. The need for additional anaesthetic was highest in Group DP at 94.3% and lowest in Group DK at 14.3%. The groups administered ketofol were observed to have a lower requirement for additional anaesthetic. Conclusion:Delirium was seen at a very low rate only in the Group MP and it is difficult to say the best combination in terms of delirium frequency. However, intranasal dexmedetomidine and IV ketofol seem to be better and safer than the other groups in terms of the need for additional doses and the number of side effects. The addition of ketamine to propofol reduces the need for additional doses with a synergistic effect.

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“…Gojendra Kumar et al (2013) 17 in their comparison between midazolam, thiopentone and ketamine as coinduction agents with propofol found the propofol dose requirement to be least with ketamine. R Kataria et al (2010) compared the mean induction doses of propofol with midazolam and propofol auto coinduction with a control group.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Small Dose of Ketamine, Midazolam and Propofol as Coinduction Agent to Propofol

Kalita¹,

Ahmed²

2017

jebmh

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BACKGROUND The technique of "coinduction", i.e. use of a small dose of sedative agent or another anaesthetic agent reduces the dose requirement as well as adverse effects of the main inducing agent. Ketamine, midazolam and propofol have been used as coinduction agents with propofol. MATERIALS AND METHODS This prospective, randomised clinical study compared to three methods of coinduction. One group received ketamine, one group received midazolam and one group received propofol as coinducing agent with propofol. RESULTS The study showed that the group receiving ketamine as coinduction agent required least amount of propofol for induction and was also associated with lesser side effects. CONCLUSION Use of ketamine as coinduction agent leads to maximum reduction of induction dose of propofol and also lesser side effects as compared to propofol and midazolam.

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Co-induction effects of midazolam, thiopentone and ketamine with propofol in general anesthesia

Cited by 6 publications

References 0 publications

Anesthetic Properties of Propofol and Ketofol (Ketamine With Propofol): A Comparative Study

Anesthetic Properties of Propofol and Ketofol (Ketamine With Propofol): A Comparative Study

The frequency of emergence delirium in children undergoing outpatient anaesthesia for magnetic resonance imaging

A Comparative Study of Small Dose of Ketamine, Midazolam and Propofol as Coinduction Agent to Propofol

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