Comparison of Propofol and Ketamine Combination (Ketofol) and Propofol and Fentanyl Combination (Fenofol) on Quality of Sedation and Analgesia in the Lumpectomy: A Randomized Clinical Trial

Nazemroaya, Behzad; Majedi, Mohammad Azad; Shetabi, Hamidreza; Salmani, Sanaz

doi:10.4103/abr.abr_85_18

Cited by 14 publications

(7 citation statements)

References 21 publications

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“…Sedation, analgesia and hemodynamic changes were reported better in Ketofol group. 15 In our study, dose of Fentanyl and Propofol in drug combination were different from the above study but we also found less sedative effect with Fenofol. Haemodynamic effects were comparable between Ketofol and Fenofol.…”

Section: I)contrasting

confidence: 84%

Comparison Between Effects of Ketofol and Fenofol as Sedative in Elective Caesarean Section Under Subarachnoid Anaesthesia

et al. 2023

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Background: Regional anaesthesia has become an important anaesthetic technique now a days. The use of spinal (subarachnoid) anaesthesia is often limited by the unwillingness of patients to remain awake during surgery. Pharmacologically induced tranquility improves acceptance of regional technique. Objective: This study compares Ketofol (Ketamine+Propofol) and Fenofol (Fentanyl+ Propofol) in terms of onset and recovery of sedation, haemodynamic effects, respiratory effects and adverse effects of both the drugs during elective Caesarian section under spinal anaesthesia. Methods: This randomized clinical trial included 60 ASA (American Society of Anaesthesiologists) grade I or II patients between age 20-40 years undergoing elective Caesarean sections under Subarachnoid anaesthesia during the period of January 2022 to June 2022. Patients were randomly allocated to one of two groups: Ketofol group (Group KP, n=30), who received Ketofol in a single dose of 0.5mg/kg (Ketamine- 0.5mg/kg+Propofol-0.5mg/kg) and Fenofol group (Group FP, n=30), who received Fenofol in a single dose of Fentanyl-0.5mcg/kg+Propofol-0.5mg/kg. Spinal anaesthesia was conducted by injecting a hyperbaric solution of 0.5% bupivacaine 3ml through a 25G spinal needle at L3-4 level. All parameters were documented at 5 min intervals until arousal of the patient. The onset of sedation i.e. time from iv (intravenous) injection of Ketofol or Fenofol to closure of eye lids and the arousal time from sedation i.e. time from closing of the eye lids to OAA/S score of 5 (patient is awake clinically) were noted. Any complication during operation was documented. Patient’s satisfaction with the sedation was assessed by the 5 point ‘Likert verbal rating scale. Results: There was no significant difference of mean blood pressure and mean heart rate between the two groups (P>0.05). Time of onset of sedation was comparable between the two groups (P>0.05). Duration of sedation was significantly less in Fenofol group (p value=<0.001). Significant percentage of patients required oxygen supplementation after sedation with Fenofol due to hypoventilation (66.66% vs 10%, p value <0.001). Incidence of nausea and vomiting was significantly more with Fenofol (46.66% vs 10%, p value >0.001). Conclusion: The study showed that the arousal time i.e. duration of sedation was significantly more with Ketofol than Fenofol which is beneficial for the patient in single dose technique for sedation. Fenofol was associated with significantly high incidence of nausea, vomiting. Moreover, significantly higher percentage of patients required O2 supplementation due to hypoventilation during sedation with Fenofol. Thus it is recommended that Ketofol is a better choice than Fenofol for sedation in single dose technique during subarachnoid block for Caesarean section. J Rang Med Col. March 2023; Vol. 8, No. 2:20-26

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Section: I)contrasting

confidence: 84%

Comparison Between Effects of Ketofol and Fenofol as Sedative in Elective Caesarean Section Under Subarachnoid Anaesthesia

et al. 2023

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“…Sedation, analgesia and hemodynamic changes were reported better in Ketofol group. 18 In our study, dose of Fentanyl and Propofol in drug combination were different from the above study. Haemodynamic effects were comparable between Fentanyl and Fenofol.…”

Section: Discussioncontrasting

confidence: 56%

Comparison between Effects of Fentanyl and Fenofol as Sedative in Elective Caesarean Section under Subarachnoid Anaesthesia

Karim¹,

Akram²,

Rashid³

et al. 2023

Khwaja Yunus Ali Medical College Journal

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Background: Regional anaesthesia has become an important anaesthetic technique now a days. Pharmacologically induced tranquility improves acceptance of regional technique. Objective: To compare Fentanyl and Fenofol (Fentanyl+Propofol) in terms of onset and recovery of sedation, haemodynamic effects, respiratory effects and adverse effects of both the drugs during elective Caesarian section under spinal(subarachnoid) anaesthesia. Materials and Methods: This randomized clinical trial included 60 ASA (American Society of Anaesthesiologists) grade I or II patients between age 20-40 years undergoing elective Caesarean sections under Subarachnoid anaesthesia during the period January 2022 to June 2022. Patients were randomly allocated to one of two groups: Fentanyl group (Group F, n=30), who received Fentanyl in a single dose of 0.5mcg/kg and Fenofol group (Group FP, n=30), who received Fenofol in a single dose of Fentanyl-0.5mcg/kg+Propofol-0.5mg/kg. Spinal anaesthesia was conducted by injecting a hyperbaric solution of 0.5% bupivacaine 3ml through a 25G spinal needle at L3-4 level. All parameters were documented at 5 min intervals until arousal of the patient. The onset of sedation i.e. time from iv (intravenous) injection of Fentanyl or Fenofol to closure of eye lids (OAA/S score of 3) and the arousal time from sedation i.e. time from closing of the eye lids to OAA/S score of 5 ( patient is awake clinically) were noted. Any complication during operation was documented. The patient’s satisfaction with the sedation was assessed by the 5 point ‘Likert verbal rating scale.’ Results: There was no significant difference of mean blood pressure and mean heart rate between the two groups in different time intervals (P>0.05). Time of onset of sedation and the arousal time i.e. duration of sedation was comparable between the two groups (P>0.05). Significant percentage of patients required O2 supplementation in Fenofol group due to hypoventilation (66.66% vs 10%, P<0.001). Pain in arm during drug administration was significantly more with Fenofol (46.66% vs 6.66%, P<0.001). Conclusion: As a significantly higher percentage of patients required O2 supplementation during sedation with Fenofol and pain in arm during drug administration was significantly more in Fenofol group, it is recommended that Fentanyl is a better choice than Fenofol for sedation in single dose technique during subarachnoid block for Caesarean section. KYAMC Journal Vol. 13, No. 04, January 2023: 234-239

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“…Psychomimetic adverse effects are known to be reduced by concomitant use of propofol [2]. Indeed, the combination has been shown to be useful in many clinical situations, with better profiles in hemodynamic stability, respiratory depression, analgesia, and recovery than each agent alone [2,5,6,7,8,9,10,11,12,13].…”

Section: Introductionmentioning

confidence: 99%

Procedural Sedation Using a Propofol–Ketamine Combination (Ketofol) vs. Propofol Alone in the Loop Electrosurgical Excision Procedure (LEEP): A Randomized Controlled Trial

Kim

Eom

et al. 2019

JCM

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Background: Although the loop electrosurgical excision procedure (LEEP) is a brief procedure, it can cause severe pain and discomfort to patients in the absence of adequate sedation. An admixture of ketamine with propofol (ketofol), may reduce patient movement due to insufficient sedation while providing hemodynamic and respiratory stability. This study evaluated the ability of two ratios of a propofol–ketamine combination, compared with propofol alone, to reduce patient movement during procedural sedation for LEEPs. Methods: One hundred and twenty women scheduled for a LEEP were randomly assigned to three groups. Anesthesia was induced with 1 mg/kg propofol (group P), 1 mg/kg propofol and 0.33 mg/kg ketamine (group K1), or 1 mg/kg propofol and 0.66 mg/kg ketamine (group K2). The primary outcome was the incidence of adduction motion in the lower extremities during the procedure. The requirements for respiratory interventions, changes in vital signs, sedation score, additional anesthetic usage, and surgeon and patient satisfaction were also evaluated. Results: The incidence of adduction motion was significantly lower in groups K1 and K2 than in group P (overall p-value <0.001) but did not differ significantly in groups K1 and K2. Group K2 needed more jaw thrust maneuvers than group K1. Additional propofol usage was lower and surgeon satisfaction scores higher in groups K1 and K2 than in group P. Conclusion: A propofol–ketamine combination is more effective than propofol alone in reducing procedural interference during LEEPs. However, increasing the dose of ketamine showed no additional benefit.

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Comparison of Propofol and Ketamine Combination (Ketofol) and Propofol and Fentanyl Combination (Fenofol) on Quality of Sedation and Analgesia in the Lumpectomy: A Randomized Clinical Trial

Cited by 14 publications

References 21 publications

Comparison Between Effects of Ketofol and Fenofol as Sedative in Elective Caesarean Section Under Subarachnoid Anaesthesia

Comparison Between Effects of Ketofol and Fenofol as Sedative in Elective Caesarean Section Under Subarachnoid Anaesthesia

Comparison between Effects of Fentanyl and Fenofol as Sedative in Elective Caesarean Section under Subarachnoid Anaesthesia

Procedural Sedation Using a Propofol–Ketamine Combination (Ketofol) vs. Propofol Alone in the Loop Electrosurgical Excision Procedure (LEEP): A Randomized Controlled Trial

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