Comparison of ketofol versus propofol for procedural sedation and analgesia in cervical cancer brachytherapy: A prospective, randomized double blind study

Most common drug used for outpatient procedural sedation and analgesia is propofol, with limitations like systemic hypotension. Combining propofol with ketamine preserves sedation efficacy, minimizing their respective adverse effects. So, we aimed to compare ketofol (ketamine+propofol) versus propofol regarding their total drug consumption, recovery profile, effect on haemodynamic and respiratory parameters in brachytherapy patients. A prospective, randomized, controlled double blind study was carried out in 100 female patients between 20-60 years, 30-70kg, ASA I-III undergoing brachytherapy as outpatient procedure on elective basis, after ethical clearance from institutional committee. These were randomly divided into 2 groups (50 each). Group P-Injpropofol (10mg/ml) 2mg/kg for induction and 20mg as supplementation. Group K-Injketofol (10mg/ml) (ketamine 50mg+propofol 100mg, 1:2) 2mg/kg for induction and 20 mg as supplementation. The supplementation dose required was significantly higher in propofol group (800mg) as compared to ketofol group (20mg) (p=0.00). Also, the fall in SBP and DBP was significantly less in ketofol group than propofol group (p<0.01). The mean awakening time (time from end of procedure to MRSS =3) andmean recovery time (time from end of procedure to achievement of Aldrete score 10) was more in ketofol group than propofol group (p<0.003), the difference was less than 1-2 min, so it was clinically not significant. Ketamine-propofol combination in 1:2 ratio in a single syringe as ketofolis better alternative to propofol in providing sedation and analgesia with better haemodynamic stability, for outpatient brachytherapy procedure in cancer cervix patients.