Comparison of propofol-remifentanil and propofol-ketamine combination for dilatation and currettage: a randomized double blind prospective trial

M. Arikan, B. Aslan, O. Arikan, A. But, E. Horasanli

Department of Anesthesiology, Faculty of Medicine, Karabuk University, Karabuk, Turkey. mugearikan@hotmail.com.tr

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• Anesthesiology

OBJECTIVE: The purpose of this study was to compare the propofol-remifentanil combination and propofol-ketamine combination for Dilatation and Curettage (DC) procedure.

PATIENTS AND METHODS: This prospective, double blind, and randomized study comprised 81 female patients undergoing diagnostic DC. Patients were randomly allocated to one of two groups; propofol-remifentanil (Group PR, n= 44) or propofol-ketamine (Group PK, n= 37). The level of sedation was assessed with the Ramsay Sedation Score (RSS). The patients’ RSS scores were maintained at 4-5 with an additional 0.5 mg/kg bolus dose of propofol. Heart rate (HR), mean blood pressure (MBP), peripheral oxygen saturation (SpO2), and RSS were recorded. The Modify Aldrete Score (MAS) was used for postoperative recovery evaluation, and the time to reach MAS score of 10 was recorded. Total dose of propofol, procedure time, side effects, and satisfaction scores of patient and surgeon were also recorded.

RESULTS: The mean HR and MBP values of Group PR were lower than those of Group PK, at all recording times. Sedation levels were significantly higher in Group PK. The total dose of propofol consumed was significantly higher in Group PR. The recovery time of Group PK was significantly longer than that of Group PF (p<0.05). Nausea-vomiting and bradycardia were more frequent in the Group PR. There was no difference in patient and surgeon satisfaction between the two groups.

CONCLUSIONS: Ketamine-propofol combination provides better hemodynamic stability and better quality of sedation than propofol-remifentanil combination. Ketamine still seems as an advantageous and safe drug for such procedure.

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