Effect of Ketofol Versus propofol as an Induction Agent on ease of Laryngeal Mask Airway Insertion Conditions and Hemodynamic Stability in Children: A Prospective Cohort Study
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Date
2017-06
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Addis Abeba University
Abstract
Background: Laryngeal mask airway is a simple supraglottic device which has led to a radical
change in the management of modern general anaesthesia. In the present study, we evaluated the
laryngeal mask airway insertion conditions and hemodynamic changes comparing ketamine-
propofol mixture (ketofol) with propofol.
Objective: The objective of this study was to compare ketamine–propofol mixture (ketofol)
with propofol on the ease of laryngeal mask airway insertion conditions for induction of general
anaesthesia (GA).The hemodynamic effects were also looked at.
Materials and Methods: In this prospective cohort study120 pediatric patients age 2 – 15 years
undergoing general anesthesia with LMA for elective ophthalmic surgeries at Menelik II
Hospital from Jan 25 -March, 25, 2017 were included. A six variable (mouth opening, ease of
insertion, swallowing, coughing, movement and laryngospasm) three-point score was used to
assess insertion conditions. LMA insertion summed score was prepared depending upon these
variables. Hemodynamic variables Heart rate and mean arterial pressure were noted 1 min before
induction (baseline), immediately after induction, immediately after insertion of LMA and 1,2
and 3 minute after LMA insertion. Insertion conditions were compared using Chi-square test
while hemodynamic variables were compared using independent t test.
Results: LMA insertion summed score was nearly similar between the two groups. Mean blood
pressure and heart rate were maintained higher in ketofol group while significant drop were
observed in propofol group. The time from the LMA placement to the return of spontaneous
ventilation was significantly longer in propofol group (240 seconds [range =60– 360 seconds])
compared with ketofol group (180 seconds [range= 30–320 seconds]) (p= 0.005).
Conclusion and Recommendations: LMA insertion condition summed score was comparable
in both ketofol and propofol group. Ketofol provided equivalent LMA insertion conditions while
maximizing hemodynamics and minimizing apnea time. When parameters such as LMA
insertion conditions and hemodynamic stability are considered, ketofol can be used as an
alternative
to
propofol for LMA insertion in pediatrics
Description
Keywords
Hemodynamic Stability; Children