Evaluation of efficacy and hemodynamic stability of propofol- ketamine and propofolfentanyl in patients undergoing dilatation and curettage

Background: To evaluate and compare the efficacy and hemodynamic stability of ketamine / fentanyl along with propofol and also assess recovery profile, post-operative analgesia and complications in patients undergoing Dilatation and Curettage (DandC). Method: Total 100 patients of ASA grade I and II, age between 18-55 years were enrolled and divided into two equal groups with adjuvant drugs in group PK- ketamine (0.75mg/kg IV) and in group PF-fentanyl (2ug/kg IV). Both groups received induction dose of Propofol- 2-2.5 mg/kg. Depth of sedation maintained with 0.5 mg/kg boluses of Inj.Propofol and assessed with Ramsay Sedation Score (RSS). The total dose of propofol was noted in both the groups. Intraoperative and postop vital parameters and complications were compared. Visual Analog Scale(VAS) was recorded and if VAS Score >6, then patients received Inj.Paracetamol 15mg/kg IV as rescue analgesia. The recovery was assessed by Modified Aldrete Score (MAS). The time from completion of procedure to reach MAS of 9-10 was noted. Results: The hemodynamics was better with ketamine than fentanyl group. The total dose of propofol requirement, intraoperative and postop complications, and VAS scores were higher in group PF than in group PK, thus more patients required rescue analgesia in fentanyl group as compared to ketamine group. The recovery was delayed in ketamine group as compared to fentanyl (higher MAS and prolonged time to reach MAS>9). Conclusion: Ketamine (0.75 mg/kg) provides better perioperative hemodynamic stability with good analgesia and fewer complications as compared to Fentanyl (2ug/kg) in patients undergoing DandC.