The Efficacy of Ketamine-Propofol Mixture Compared with Propofol on I-Gel Laryngeal Mask Airway Insertion for Anesthesia in Elderly Patients
Keywords:
hemodynamics, ketamine-propofol mixture, ketofol, laryngeal mask airway insertion, elderlyAbstract
According to the upward trend of laryngeal mask airway using in general anesthesia, the dose of propofol which decreased upper airway reflex usually causes hypotension incidences in elderly patients. The purpose of this research is to evaluate the efficacy of ketofol (ketamine 0.75 mg/kg and propofol 1.5 mg/kg) compared with propofol 1.5 mg/kg on I-gel laryngeal mask airway (LMA) insertion conditions and hemodynamics for induction of general anesthesia in elderly patients. This was a prospective randomized controlled trial. Subjects were elderly patients (≥ 65-year-old) with ASA status 2-3 who had indication for general anesthesia (GA) at Mahasarakham hospital in October to November 2023. They were randomly divided into two groups; ketofol and propofol groups received either ketofol or propofol for induction of GA with I gel LMA insertion, respectively. Demographic and hemodynamic variables were recorded. Appropriate I gel LMA position was evaluated and scored by nurse anesthetists whom blinding from induction medication. Hemodynamic and complications were assessed at post anesthetic care unit (PACU) until 24 hours post operation. Descriptive statistics, Chi-square, and Fisher exact test were used in statistics analysis. The result was considered statistically significant if the two-sided p-value was less than 0.05.
Results: A total of 51 elderly cases were enrolled, 27 and 24 cases were recruited in ketofol and propofol groups. Both groups had no different in comparable of age, ASA status, and type of surgery. Hemodynamic change (lowering of heart rate and blood pressure) and insertion summed score for I gel LMA insertion of both groups were comparable (p=0.461). There were 1 and 2 cases of hallucinations and nightmare in ketofol group.
Conclusions: There was no difference between ketamine-propofol mixture and propofol comparison in hemodynamic changes and insertion summed score for I gel LMA in elderly patients, but the ketofol group had more hallucination and nightmare.
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