COMPARISON OF ANESTHETIC EFFECTIVENESS BETWEEN PROPOFOL AND KETOFOL IN ANESTHESIA FOR FLEXIBLE BRONCHOSCOPY IN CHILDREN
Main Article Content
Abstract
Objective: To compare the anesthetic effectiveness of propofol and ketofol during flexible bronchoscopy in children. Subjects and Methods: A clinical intervention study was conducted on 60 children scheduled for bronchoscopy at the National Lung Hospital from February 2024 to August 2024. The patients were randomly divided into two groups: the propofol group, which received propofol anesthesia, and the ketofol group, which received a combination of ketamine and propofol in a 1:1 ratio. Results: the onset time of propofol was faster than ketofol: 4.12 ± 0.23 minutes vs. 4.37 ± 0.6 minutes, p < 0.05. The recovery time was also faster with propofol compared to ketofol, with a significant difference (p < 0.05). The time to spontaneous eye-opening was 7.8 ± 4.5 minutes for propofol and 13.7 ± 3.6 minutes for ketofol. The time to obey commands was 4.15 ± 2.3 minutes for propofol and 8.06 ± 1.8 minutes for ketofol. Endoscopists were more satisfied with ketofol. The number of times for interupted endoscopy and given additional drugs because the patients did not cooperate in the ketofol group was statistically significantly lower than in the propofol group alone. Conclusion: ketofol has a longer onset and recovery time compared to propofol, but provides higher satisfaction for the performing physicians.
Article Details
Keywords
Ketofol, propofol, bronchoscopy, children.
References


2. Foo TY, Noor NM, Yazid MB, Fauzi MH, Wahab SFA, Ahmad MZ. Ketamine-propofol (Ketofol) for procedural sedation and analgesia in children: a systematic review and meta-analysis. BMC Emergency Medicine. 2020;20. doi:10.1186/ s12873-020-00373-4


3. Schmitz A, Weiss M, Kellenberger C, et al. Sedation for magnetic resonance imaging using propofol with or without ketamine at induction in pediatrics—A prospective randomized double-blinded study. Pediatric Anesthesia. 2018;28(3): 264-274. doi:10.1111/pan.13315


4. Tosun Z, Aksu R, Guler G, et al. Propofol‐ketamine vs propofol‐fentanyl for sedation during pediatric upper gastrointestinal endoscopy. Pediatric Anesthesia. 2007;17(10): 983-988. doi:10.1111/j.1460-9592.2007.02206.x


5. Soliman R, Mofeed M, Momenah T. Propofol versus Ketofol for Sedation of Pediatric Patients Undergoing Transcatheter Pulmonary Valve Implantation: A Double-blind Randomized Study. Ann Card Anaesth. 2017;20(3):313-317. doi:10. 4103/aca.ACA_24_17


6. Miner JR, Moore JC, Austad EJ, Plummer D, Hubbard L, Gray RO. Randomized, Double-Blinded, Clinical Trial of Propofol, 1:1 Propofol/Ketamine, and 4:1 Propofol/Ketamine for Deep Procedural Sedation in the Emergency Department. Annals of Emergency Medicine. 2015;65(5): 479-488.e2. doi:10.1016/ j.annemergmed.2014.08.046


7. David H, Shipp J. A Randomized Controlled Trial of Ketamine/Propofol Versus Propofol Alone for Emergency Department Procedural Sedation. Annals of Emergency Medicine. 2011;57(5):435-441. doi:10.1016/j.annemergmed.2010.11.025


8. Hayes JA, Aljuhani T, De Oliveira K, Johnston BC. Safety and Efficacy of the Combination of Propofol and Ketamine for Procedural Sedation/Anesthesia in the Pediatric Population: A Systematic Review and Meta-analysis. Anesthesia & Analgesia. 2021;132(4): 979. doi:10.1213/ANE.0000000000004967.

