Comparison of Analgesic Requirement and Pain Intensity in Lower Segment Cesarean Section (LSCS) with Ketofol and Conventional Induction of General Anesthesia

Abstract

Objective: to compare the analgesic requirement and pain intensity in LSCS with ketofol and conventional induction of general anesthesia

Study Type: randomized controlled trial

Study Place and Duration: department of Anesthesiology at Ghazi Medical College & Teaching Hospital, Dera Ghazi Khan, from 1^st January 2019 to 30^th June 2019.

Material and methods: 100 adult participants (20–40 years) ASA physical status 1 and 2, with no previous case of neurologic or cardiovascular undergoing LSCS operations were enlisted in a randomised prospective comparative study after receiving approval from the ethical research committee. Patients were divided into two groups, each with 50 patients: group P (propofol) and group KP (ketamine) (ketofol). The surgeon picked a closed envelope as the method of randomization. Visual analogue scale was used to assess the postoperative pain where, 0 means no pain, 1-3 means mild pain, 4-7 means moderate pain, and 8-10 means severe pain using a visual analog scale, where 0 means no pain, 1-3 means mild pain, 4-7 means moderate pain, and 8-10 means severe pain. Furthermore, the need for postoperative analgesia was examined, including the need for fentanyl.

Results: The majority of the patient's Group P and Group KP had 0 VAS scoresof28 (56.0%) and 26 (52.0%), respectively, (p=0.475). Intra operation fentanyl was required 3 (6.0%) in Group P and 1 (2.0%) in Group PK, (p=0.307). While, post-operation fentanyl was required 7 (14.0) in Group P and 4 (8.0) in Group PK, (p=0.338).

Conclusion: Ketofol as an induction agent can be used as an alternative which is relatively safe and show less side effects in comparison to propofol alone.

Keywords: Ketamine, propofol, ketofol, pain intensity, analgesia requirement, conventional induction, general anesthesia