Prospective Study of Dexmedetomidine-Propofol versus Dexmedetomidine-Ketamine for Sedation and Anesthesia in Hysteroscopic Examination and Procedures

Narra, Gopal Reddy; M, Kahalekar Govind; Reddy, Chandra Shekar; M, Pramod Kumar

doi:10.21088/ijaa.2349.8471.42(pt-ii)17.12

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“…Koruk et al observed that recovery time was significantly shorter in the propofol-dexmedetomidine combination than in propofol-ketamine in pediatric patients undergoing transcatheter ASD closure [ 11 ]. Gopal et al noted post-procedural recovery time to be significantly shorter in the dexmedetomidine-ketamine group compared to the dexmedetomidine-propofol group in patients scheduled for hysteroscopy [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Intravenous Dexmedetomidine-Ketamine Versus Ketamine-Propofol for Procedural Sedation in Adults Undergoing Short Surgical Procedures: A Randomized Controlled Trial

Kakarla,

Senapati,

Das

et al. 2023

Cureus

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Background and objectiveModerate to deep sedation is a prerequisite during total intravenous anesthesia for short-duration surgeries, and it can be achieved by using individual drugs or in combination. Our study compared dexmedetomidineketamine (DK) versus ketamine-propofol (KP) in terms of sedation, procedural interference, hemodynamics, and incidence of side effects in patients undergoing short surgical procedures. MethodsA total of 194 patients scheduled for short-duration elective surgeries were randomly allocated into two groups. Group DK received a loading dose of 1 µg/kg of dexmedetomidine and 1 mg/kg of ketamine followed by a maintenance infusion of dexmedetomidine at 0.3 µg/kg/h. Group KP received a loading dose of 1 mg/kg of ketamine and 1 mg/kg of propofol followed by a maintenance infusion of propofol at 25 µg/kg/h. For procedural interference, a rescue ketamine bolus was administered at 0.25 mg/kg. Patients were monitored for the requirement of rescue ketamine bolus, procedural interference, hemodynamics, sedation, recovery time, and adverse effects. ResultsThe procedural interference was higher in group KP than in group DK and the difference was statistically significant (P=0.001). The time to the first rescue bolus was 8.72 ± 4.47 minutes in group KP and 10.82 ± 4.01 minutes in group DK, with a difference of 2.1 minutes (p=0.026). There was no statistically significant difference in the sedation scores between both groups except at time points of six minutes and 15 minutes. ConclusionFor short-duration procedures, the DK combination is superior to the KP combination in terms of procedural interference and time to the first rescue bolus, while both groups were comparable with regard to safety and hemodynamics.

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Section: Discussionmentioning

confidence: 99%

“…[11]. Gopal et al noted post-procedural recovery time to be significantly shorter in the dexmedetomidineketamine group compared to the dexmedetomidine-propofol group in patients scheduled for hysteroscopy [19].…”

Section: Recovery Timementioning

confidence: 99%