Comparison of hemodynamic response of small dose ketamine versus midazolam as co- induction agent to propofol: a randomized double blind interventional study

Authors

  • Sunil Chauhan Department of Anaesthesia, SMS Medical College & Hospital, Jaipur, Rajasthan
  • Sandeep Kothari Department of Anaesthesia, RUHS Medical College & Hospital, Jaipur, Rajasthan
  • Nitish Chaudhary Department of Anaesthesia, SMS Medical College & Hospital, Jaipur, Rajasthan
  • Kiwi Mantan Department of Anaesthesia, SPMC Medical College & Hospital, Bikaner, Rajasthan

DOI:

https://doi.org/10.18231/j.joapr.2023.11.2.12.19

Keywords:

Ideal Induction agent, Ketamine, Midazolam, Hemodynamic stable induction agent

Abstract

The Anaesthesiology Department at Sawai Man Singh Medical College carried out this study. For this, 60 ASA grade I and II patients undergoing planned general surgery were randomly assigned into two groups of 30 each, with Group KP (n=30) receiving injections of ketamine at 0.3 mg/kg and Group MP receiving injections of midozolam at 0.03 mg/kg and Propofol I.V. The main goal of the study was to find the best induction by analysing changes in hemodynamic indicators from baseline to various time points after induction. On the basis of the necessary induction dose and hemodynamic characteristics, the groups were contrasted. The strategy used was to present the categorical data as percentages and compare them between groups using the Chi square test. The mean and standard deviation of the quantitative data were displayed, and students' t-tests were used to compare them. According to the study described above, group MP saw a greater fluctuation in heart rate than did group KP, whose heart rate remained more constant during the anaesthetic time. Group MP's blood pressure dropped more quickly after induction compared to group KP. The ketamine group's blood pressure remained the most stable out of all the groups. Apnea, pain upon injection, and uncontrollable movements were absent in the KP group. Of all the groups, the ketamine-propofol group required the least induction dose. As a result, we came to the conclusion that pretreatment with ketamine at a dose of 0.3 mg/kg results in better hemodynamic stability and requires less propofol for induction than midazolam does. The ketamine-propofol group is therefore the best of the two groups, making it the optimum induction agent

Downloads

Download data is not yet available.

References

Djaiani G, Ribes-Pastor MP. Propofol auto-co-induction as an alternative to midazolam co-induction for ambulatory surgery. Anaesthesia 54, 63-7. (1999).

Gray C, Swinhoe CF, Myint Y, Mason D. Target controlled infusion of ketamine as analgesia for TIVA with propofol. Can J Anaesth 46, 957-61. (1999).

Anderson L, Robb H. A comparison of midazolam co-induction with propofol predosing for induction of anaesthesia. Anaesthesia 53, 1117-20. (1998).

Furuya A, Matsukawa T, Ozaki M, Nishiyama T, Kume M, Kumazawa T. Intravenous ketamine attenuates arterial pressure changes during the induction of anaesthesia with propofol. Eur J Anaesthesiol 18, 88-92. (2001).

Srivastava U, Sharma N, Kumar A, Saxena S. Small dose propofol or ketamine as an alternative to midazolam co induction to propofol. J. Anaesth. 50(2), 112-114 (2006)

Tomatir E, Atalay H, Gurses E, Erbay H, Bozkurt P. Effects of low dose ketamine before induction on propofol anesthesia for pediatric magnetic resonance imaging. Paediatr Anaesth 14, 845-50. (2004).

Hui TW, Short TG, Hong W, Suen T, Gin T, Plummer J. Additive interactions between propofol and ketamine when used for anesthesia induction in female patients. Anesthesiology 82, 641-8. (1995).

Short TG, Chui PT. Propofol and midazolam act synergistically in combination. Br J Anaesth 67, 539-45. (1991).

Wilder-Smith OH, Ravussin PA, Decosterd LA, Despland PA, Bissonnette B. Midazolam premedication reduces propofol dose requirements for multiple anesthetic endpoints. Can J Anaesth 48, 439-45. (2001).

Tan CH, Onsiong MK, Kua SW. The effect of ketamine pretreatment on propofol injection pain in 100 women. Anaesthesia 53, 302-5. (1998).

Published

2023-06-30

How to Cite

Chauhan, S. ., Kothari, S., Chaudhary, N. ., & Mantan, K. (2023). Comparison of hemodynamic response of small dose ketamine versus midazolam as co- induction agent to propofol: a randomized double blind interventional study. Journal of Applied Pharmaceutical Research, 11(2), 12-19. https://doi.org/10.18231/j.joapr.2023.11.2.12.19

Issue

Section

Articles