A Prospective Evaluation of Different Ketofol Concentrations for Sedation and Analgesia in Catarct Surgery Performed Under Local Anesthesia

Abstract Background: Ketofol is a mixture of ketamine and propo-fol. It is one of the agents known to achieve procedural sedation and analgesia. Aim of Study: This prospective randomized study compared the effectiveness and safety of four doses of ketofol for sedation and analgesia in catarct surgery performed under local anesthesia. Patients and Methods: 80 adult patients aged between 40-65 years of both sexes, scheduled for cataract extraction and intraocular lens implantation, were enrolled in this, interventional study. They were divided into 4 groups of 20 patients each. Results: In the present study as regards to haemodynamics (HR & MAP), we found most patients developed modest increases in pulse rate and blood pressure in all groups but the higher increase was found in groups I & II compared to III & IV. As regards to mean oxygen saturation and respiratory rate in the current study there was lower mean oxygen satu-ration in groups III and IV after 5 minutes of drug infusion (T1) compared to the other groups. However, the difference is not statistically significant (p-value >0.05). Mean IOP after sedation was significantly higher among groups I & II com-pared to groups III & IV (p-value <0.05) which is related to the ketamine high doses. Conclusion: This current study suggests that Ketofol (ketamine/propofol concentration) at a ratio 3:1 and 4:1 may provide effective and safe sedation for patients undergoing ophthalmic procedures under regional anesthesia. An intrave-nous infusion of a 4:1 ratio is a suitable alternative for delivering ketofol, this provides more stability and consistency of sedation depth and less need for top-up doses that may lead to overshoot of sedation and a delayed recovery.