The effects of ketamine-propofol (ketofol) ratio in the mixing proportions of ketofol on hemodynamic response to endotracheal intubation

ABSTRACT

BACKGROUND: Hemodynamic stability can be achieved using the combination of ketamine and propofol (ketofol). This study was designed to compare the hemodynamic effects of ketofol with different ketamine-propofol ratios versus propofol after induction of general anesthesia with endotracheal intubation. METHODS: A total of 120 American Society of Anesthesiologist physical status I and II patients 20-60 years of age were randomly allocated into one of four groups. The K0 group received only 2 mg/kg propofol. The K0.15 group received 0.15 mg/kg ketamine and 1.85 mg/kg propofol. The K0.3 group received 0.3 mg/kg ketamine and 1.7 mg/kg propofol. The K0.6 group received 0.6 mg/kg ketamine and 1.4 mg/kg propofol. Endotracheal intubation was performed after muscle relaxation. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), heart rate (HR) and the bispectral index value were recorded. RESULTS: No significant differences were observed in SBP, DBP, MBP, or HR among the groups after endotracheal intubation. However, the number of patients with a decrease of MBP > 20% from baseline after induction was significantly lower in the K0.6 group compared to that in the K0 group (P < 0.05). CONCLUSIONS: The results suggest that ketofol with 0.6 mg/kg ketamine and 1.4 mg/kg propofol can be used as an alternative to 2 mg/kg propofol.