NGHIÊN CỨU PHỐI HỢP PROPOFOL VÀ KETAMIN TRONG KHỞI MÊ ĐẶT MASK THANH QUẢN CHO PHẪU THUẬT BỎNG

Abstract

Objective: To evaluate the efficacy and safety of a propofol-ketamine combination for induction and laryngeal mask airway (LMA) insertion in adult burn patients undergoing debridement and skin grafting surgery. Methods: A prospective, uncontrolled interventional study was conducted on 30 adult patients (≥18 years, ASA I-III) undergoing burn debridement and skin grafting under general anesthesia at Le Huu Trac National Burn Hospital. Anesthesia was induced using a propofol-ketamine combination, followed by LMA insertion and maintenance with propofol infusion. The evaluated parameters included time to loss of consciousness, time to adequate conditions for LMA insertion, insertion conditions, hemodynamic changes (heart rate and mean arterial pressure), and peri-induction adverse events. Results: The mean time to loss of consciousness was 58.60 ± 9.40 seconds, and the time to adequate LMA insertion conditions was 179.30 ± 17.80 seconds. The mean induction doses were 108.63 ± 28.78 mg for propofol and 44.70 ± 8.10 mg for ketamine; fentanyl 100 µg was administered in all cases. Optimal or good LMA insertion conditions were achieved in 100% of patients, with a 100% first-attempt success rate. Additional propofol was required in 3 patients (10%). Heart rate and mean arterial pressure decreased slightly after induction and after LMA insertion, remaining within clinically acceptable ranges. No cases of hypotension, bradycardia, or vasopressor requirement were observed. Conclusion: Combination propofol-ketamine provides rapid induction, favorable conditions for LMA insertion, and stable hemodynamics. This technique appears to be effective and safe for short-duration burn surgeries.