title: Ideal anesthetic agents for day-care gynecological procedures: A clinical trial comparing thiopentone with ketamine as adjuncts to propofol.
abstract: BACKGROUND
  Day-care gynecological procedures require the use of anesthetic agents, which ensure rapid induction and recovery. Although propofol is the gold standard drug in day-care procedures, it has its own side effects like apnea, cardiovascular instability, pain on injection, as well as its cost. The ideal drug combination to achieve this end remains elusive. Therefore, a combination of propofol, thiopentone, and ketamine may be a better alternative.
  
  
  METHODS
  This prospective, double-blind, randomized study was conducted on 60 women, aged 18-50 years, American Society of Anesthesiologists (ASA) physical status 1 and 2, undergoing day-care gynecological surgeries. The patients were allocated to two groups. Group T received an admixture containing 10 ml of 1% propofol and 10 ml of 1.25% thiopentone. Group K received an admixture containing 10 ml of 1% propofol and 10 ml of 0.5% ketamine.
  
  
  RESULTS
  There was less variation in the mean systolic blood pressure of patients in Group K as compared to patients in Group T. The mean total dose of propofol required in Group K (0.85 mg/kg) was significantly less than that required in Group T (1.12 mg/kg) (P = 0.0004). The mean recovery time in Group T (3.67 minutes) was significantly less than in Group K (6.27 minutes; P = 0.0001). However, the mean discharge time in both the groups was similar. (P = 0.7392). The results were analyzed statistically using the Student's t-test and the Fisher's exact test.
  
  
  CONCLUSIONS
  Both the propofol-thiopentone and propofol-ketamine admixtures provided adequate anesthesia. Propofol-ketamine proved superior to propofol-thiopentone in terms of hemodynamic stability and requirement of a lesser total dose of propofol. However, the patients in the propofol-thiopentone group had faster recovery.
authors.affiliation: Department of Anesthesia and Critical Care, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: Hemani
authors.initials: H
authors.lastname: Ahuja
authors.affiliation: Department of Anesthesia and Critical Care, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: Valsamma
authors.initials: V
authors.lastname: Abraham
authors.affiliation: Department of Anesthesia and Critical Care, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: John
authors.initials: J
authors.lastname: Abraham
authors.affiliation: Department of Anesthesia and Critical Care, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: Dootika
authors.initials: D
authors.lastname: Liddle
keywords: Day care; gynecological surgeries; ketamine; propofol; thiopentone