Publication:

A comparative study of total intravenous anesthesia with propofol/ketamine and propofol/tramadol combinations in orthopedic outpatient procedures

Background Propofol opioid/nonopioid combinations provide adequate analgesia during and after surgery. The aim of this study was to compare the effect of anesthesia with propofol/ketamine versus propofol/tramadol on the haemodynamic parameters and pain in patients undergoing orthopaedic outpatient surgical procedures.

Methods Fifty patients with ASA status I-II between the age group of 20-50 years undergoing orthopaedic outpatient surgical procedures under general anesthesia were randomly assigned to propofol/ ketamine (n=25, group I) and propofol/ tramadol (n=25, group II) groups. Patients in group I were induced with propofol 150 μg/kg/min IV and ketamine 50 μg/kg/min IV and in group II induction was performed with propofol 150 μg/kg/min IV and tramadol 1 mg/kg/min. IV. The hemodynamic parameters, oxygen saturation (SpO2), respiration rate, sedation and pain were measured before and after induction at predefined time points and were compared between groups.

Results There was significant difference between groups in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR). SBP, DBP and HR were stable in patients induced with propofol/ketamine. The SBP, DBP and HR decreased significantly after induction with propofol/tramadol compared to premedication, but tends to return to normal after 25 minutes. No significant changes in SpO2 found in both the groups at all-time points. Both groups are sedated and showed no difference in pain score with few episodes of unpleasant dreams or hallucinations or adverse complications.

Conclusions Propofol/tramadol anesthesia in patients undergoing orthopaedic procedures provided stable hemodynamic and respiratory stability, sedation and pain reduction as effective as propofol/ketamine anesthesia.