Comparison of the efficacy of two-drug combination, ketofol and fenofol, on sedation and analgesia in patients under the surgery of port catheter placement and removal

Abstract

Background: Placement and removal of port catheter is often done by local anesthesia and sedation. Due to the duration of this surgery, it is necessary to use drugs or drugs combination. These drugs should have two distinct features, firstly, the onset of the effect and the return of alertness should be fast, and secondary it should have adequate sedation and analgesia, and can provide proper cardiovascular and respiratory function, amnesia, and inactivity. Methods: Using convenience sampling method, and considering inclusion and exclusion criteria, 68 patients candidate for placement and removal of port catheter were entered randomly into two groups receiving propofol-ketamine (ketofol) and propofol-fentanyl (fenofol). Anesthetics induction was done in ketofol group with propofol (1 mg/kg) and ketamine (0.5 mg/kg), and in fenofol group with propofol (1 mg/kg) plus fentanyl (1.5 μg/kg). Then, the procedure was performed by the surgeon. During the procedure, depth of sedation was assessed using Ramsay scale, as well as pain intensity using visual analogue scale (VAS). Patients were monitored for hemodynamic changes before, during, and after the surgery. Findings: Sedation (P = 0.94) and analgesia (P = 0.58), as well as hemodynamic changes (P > 0.05 for all) were reported better in ketofol group. The duration of surgery (P = 0.04) and recovery (P = 0.12) in the ketofol group was upper, but the amount of motion during operation (P = 0.54) and the need for a re-dose of drug (P = 0.01) was lower in this group. Conclusion: The drug combination of propofol-ketamine is suggested to be used in patients under chemotherapy. © 2019, Isfahan University of Medical Sciences(IUMS). All rights reserved.