Effect Of Ketofol Versus Propofol As An Induction Agent On Ease Of Laryngeal Mask Airway Insertion Conditions And Hemodynamic Stability In Children A Prospective Cohort Study

Background: Laryngeal mask airway is a simple supraglottic device which has led to a radicalrnchange in the management of modern general anaesthesia. In the present study, we evaluated thernlaryngeal mask airway insertion conditions and hemodynamic changes comparing ketamine-rnpropofol mixture (ketofol) with propofol.rnObjective: The objective of this study was to compare ketamine–propofol mixture (ketofol)rnwith propofol on the ease of laryngeal mask airway insertion conditions for induction of generalrnanaesthesia (GA).The hemodynamic effects were also looked at.rnMaterials and Methods: In this prospective cohort study120 pediatric patients age 2 – 15 yearsrnundergoing general anesthesia with LMA for elective ophthalmic surgeries at Menelik IIrnHospital from Jan 25 -March, 25, 2017 were included. A six variable (mouth opening, ease ofrninsertion, swallowing, coughing, movement and laryngospasm) three-point score was used tornassess insertion conditions. LMA insertion summed score was prepared depending upon thesernvariables. Hemodynamic variables Heart rate and mean arterial pressure were noted 1 min beforerninduction (baseline), immediately after induction, immediately after insertion of LMA and 1,2rnand 3 minute after LMA insertion. Insertion conditions were compared using Chi-square testrnwhile hemodynamic variables were compared using independent t test.rnResults: LMA insertion summed score was nearly similar between the two groups. Mean bloodrnpressure and heart rate were maintained higher in ketofol group while significant drop werernobserved in propofol group. The time from the LMA placement to the return of spontaneousrnventilation was significantly longer in propofol group (240 seconds [range =60– 360 seconds])rncompared with ketofol group (180 seconds [range= 30–320 seconds]) (p= 0.005).rnConclusion and Recommendations: LMA insertion condition summed score was comparablernin both ketofol and propofol group. Ketofol provided equivalent LMA insertion conditions whilernmaximizing hemodynamics and minimizing apnea time. When parameters such as LMArninsertion conditions and hemodynamic stability are considered, ketofol can be used as anrnalternativerntornpropofol for LMA insertion in pediatrics

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