A comparison of ketaminepropofol combination with propofol for sedation during diagnostic hysteroscopy

There has been an increasing interest to a combination of ketamine and propofol (ketofol) in recent years. It seems that ketamine increases blood pressure and attenuates hemo-dynamic effects of propofol. The sedative effect of ketamine lowers propofol dose in combi-nation which can reduce the incidence of apnea. The other point is that propofol has the antiemetic and strong sedative effects thus reducing the psychiatric adverse effects of ketamine. There are many uncontrolled studies about ketofol combination and its sedative effect and in the other controlled clinical trials the results were controversial. Comparison of Ketofol (Ketamine-Propofol combination) with Propofol for sedation during hysteroscopy. In a double blind clinical trial patients were divided into two groups (n=20). One group was sedated with propofol and the other received ketofol. Vital signs and BIS (Bispesteral Index Score) were recorded before induction and after the patients sedated to a Ramsey Sedation Score of 6. Vital signs, side effects & duration of recovery were compared in both groups. Demographics and vital signs were the same before induction in two groups. There were no significant differences about BIS and hemodynamic changes between groups (p values respectively 0/29, 0/83 and 0/75). Incidence of apnea and side effects in recovery were similar in both groups. Recovey period was significantly longer in ketofol group than propofol group (p=0/008). It can be concluded from the present study that there are no differences between ketofol and propofol alone as regards deep sedation in young ASA I and II patients undergoing outpatientsurgery. Ketofol prolongs recovery period which suggests that ketofol is not an appropriate drug for outpatients sedation. There is no significant hemodynamical difference between ketofol and propofol for deep sedation.