Volume : 7, Issue : 3, March - 2018

Total Intravenous Anaesthesia: Comparison of Propofol--Ketamine and Propofol- Dexmedetomidine combinations

Kanhaiya Lal Kishnani, Sanjay P Dave, Akansha Bansal

Abstract :

<p>&nbsp;</p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;&#10;mso-bidi-theme-font:minor-bidi">Rising cost of medical treatment and the reimbursement of medical expenses by medical insurance provider companies&rsquo; emphasis on day care surgery are on rise. Previously day care surgeries were being performed under General Anaesthesia which is costlier than TIVA. GA require specific vaporizers for inhalational volatile </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:Calii;&#10;mso-bidi-theme-font:minor-latin;color:black;mso-fareast-language:EN-IN">anaesthetics requiring frequent caliations and maintenance</span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-bidi-theme-font:minor-bidi"> and produces pollution of working area.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:8.3pt;margin-right:0in;margin-bottom:8.3pt;&#10;margin-left:0in;background:white"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&#10;&quot;Times New Roman&quot;;mso-bidi-font-family:Calii;mso-bidi-theme-font:minor-latin;&#10;color:black;mso-fareast-language:EN-IN">TIVA has advantages of smooth induction and maintenance of anaesthesia, fewer incidences of side post operative nausea and vomiting, smooth recovery and minimal side effects,<span style="mso-spacerun:yes">&nbsp; </span>has predictable action of drugs, the oxygen demand is minimal or nil. TIVA can be practised easily in less equipped hospitals and, convenient to use. The search for newer and more convenient as well as safer combinations of drugs in TIVA is being done to achieve the goals.</span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-bidi-theme-font:minor-bidi"><span style="mso-spacerun:yes">&nbsp;&nbsp;&nbsp; </span><o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;&#10;mso-bidi-theme-font:minor-bidi"><span style="mso-spacerun:yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>The main aim of study was to compare two combinations of drugs 1) Propofol and Ketamine and 2) Propofol and </span><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&#10;&quot;Times New Roman&quot;;mso-bidi-font-family:Calii;mso-bidi-theme-font:minor-latin;&#10;color:black;mso-font-kerning:18.0pt;mso-fareast-language:EN-IN;mso-bidi-font-weight:&#10;bold">Dexmedetomidine in TIVA for short surgical procedures.</span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-bidi-font-family:AdvTimes-i"><span style="mso-spacerun:yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span style="mso-spacerun:yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-bidi-theme-font:minor-bidi"><o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;&#10;mso-bidi-theme-font:minor-bidi"><span style="mso-spacerun:yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>Material and Method</span><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-bidi-font-family:&#10;AdvTimes;color:black"><o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;mso-layout-grid-align:none;&#10;text-autospace:none"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-bidi-font-family:AdvTimes;color:black">Total 100 patients of between the age group of 20 years to 65 years belonging to ASA Group I and II of either sex undergoing short surgical procedures were included in the study.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:8.3pt;margin-right:0in;margin-bottom:8.3pt;&#10;margin-left:0in;background:white"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-bidi-font-family:&#10;AdvTimes;color:black">The patients were divided in two groups, one group of 50 patients each. Group 1) PK group received Propofol and Ketamine, while group 2) PD group received Propofol and dexmedetomidine combination. In group I (PK) the induction was done with</span><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&#10;&quot;Times New Roman&quot;;mso-bidi-font-family:Calii;mso-bidi-theme-font:minor-latin;&#10;color:black;mso-fareast-language:EN-IN"> Propofol 1.0 mg/kg body wt. and Ketamine 1.0 mg/kg body wt and in group II (PD group) induction was done with Propofol 1.0 mg/kg body wt. plus D<span style="mso-font-kerning:18.0pt;&#10;mso-bidi-font-weight:bold">exmedetomidine 1.0 mcg</span> /kg body wt. Vital parameters were continuously monitored. All the patients of both groups were monitored and followed up in post operative period for any symptoms. <o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:8.3pt;margin-right:0in;margin-bottom:8.3pt;&#10;margin-left:0in;background:white"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&#10;&quot;Times New Roman&quot;;mso-bidi-font-family:Calii;mso-bidi-theme-font:minor-latin;&#10;color:black;mso-fareast-language:EN-IN"><span style="mso-spacerun:yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>Conclusion</span><span lang="EN-IN" style="font-size:12.0pt;line-height:&#10;115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-bidi-font-family:AdvTimes;&#10;color:black"><o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;&#10;mso-bidi-theme-font:minor-bidi">Present study suggest that both the combinations of Propofol and Ketamine as well as Propofol and Dexmedetomedine are equally effective in TIVA, the less hemodynamic effects, minimal side effects and are safe. The recovery features are identical in post operative period. Both the combinations produce rapid, pleasant, smooth and swift recovery with minimal residual impairment of mental functions with stable hemodynamic status. <o:p></o:p></span></p>

Keywords :


Cite This Article:

KANHAIYA LAL KISHNANI, SANJAY P DAVE, AKANSHA BANSAL, Total Intravenous Anaesthesia: Comparison of Propofol--Ketamine and Propofol- Dexmedetomidine combinations, GLOBAL JOURNAL FOR RESEARCH ANALYSIS : VOLUME-7, ISSUE-3, MARCH-2018


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