Comparison between the effects of propofol-ketamine and propofol-fentanyl for sedation in cataract surgery

Considering the importance of proper sedation in cataract surgery, this study was conducted to make a comparison between the effects of ketamine-propofol combination and fentanyl-propofol combination for sedation in phacoemulsification surgery. In this clinical trial study, 84 patients who were candidates for phacoemulsification cataract surgery were assigned to two groups. Each group consisted of 42 patients. Ketamine-propofol combination and fentanyl-propofol combination were used for induction of sedation for the first and second groups respectively. We assessed and compared sedation depth (using Ramsay score), hemodynamic parameters during operation and recovery, and satisfaction of the patients and surgeons between the two groups. There were no significant differences between the two groups in terms of baseline variables, demographic characteristics, sedation index and patient and surgeon satisfaction.
There was no significant difference between two groups in relation to blood pressure during operation and recovery periods but the heart rate at the 10th minute of the operation and at the beginning of the recovery in the ketofol group was significantly higher, and also the mean Spo2 was higher in the ketofol group at the 10th minute of operation. Patients in the ketofol group showed less hemodynamic changes. Both combinations of ketamine-propofol and fentanyl-propofol were associated with the effective sedation, satisfaction of the patients and the surgeons. But generally, hemodynamic status was more stable in the patients in the ketofol group.