Efficacy of Ketofol in Blunting Hypotensive Effects of Propofol during Induction and Its Effect on Intraoperative Anesthetic Requirements and Recovery Profile

BACKGROUND: Major disadvantage of propofol is dose-dependent hypotension. AIM OF THE STUDY: The aim of the study was comparison of changes in heart rate (HR) and mean arterial pressure (MAP) after induction with propofol versus ketofol (a combination of ketamine and propofol). SETTINGS AND DESIGN: This was a prospective randomized study conducted in a tertiary care institute. SUBJECTS AND METHODS: Sixty patients were recruited. Group A patients were induced with 1.5–2.5 mg.kg(−1) propofol. In Group B, ketamine 1 mg.kg(−1) was given intravenously followed by propofol 1–2 mg.kg(−1). All patients received standardized intraoperative management. STATISTICAL TESTS USED: Chi-square test, independent sample t-test, and paired t-test were used for statistical analysis. RESULTS: Baseline HR and HR immediately after induction were comparable in both groups. There was a significant decrease in mean HR at 3 min postinduction in Group A compared to Group B (65.7 ± 5.4 vs. 80.8 ± 12.4). At 1 min postintubation, there was a significant rise in HR in Group A (103.5 ± 12.4 vs. 84.8 ± 9.5). HR remained comparable in both groups at other timelines. Baseline MAP was comparable between groups. Mean MAP in Group A was significantly lower than Group B immediately after induction and at 3 min postinduction. MAP was significantly higher in Group A at 1 min postintubation and remained comparable at other time points. The incidence of hypotension was significantly higher in Group A compared to Group B. CONCLUSION: Combining ketamine 1 mg.kg(−1) to propofol blunted hypotensive and bradycardic effects of propofol. Ketofol effectively attenuated hemodynamic responses to intubation and was associated with reduced intraoperative opioid consumption with no added risks of excessive postoperative sedation or emergence delirium.