Anaesthesia Induction with Ketamine: Propofol Combination (Ketofol) in Caesarean Delivery

OBJECTIVE: The aim of this study was to compare the maternal and foetal effects of ketamine: propofol (ketofol) combination with thiopental, used in anaesthesia induction for caesarean delivery. METHODS: Eighty, 18-35 years-old parturients in ASA I-II class, who were admitted for caesarean delivery under general anaesthesia, were allocated to this prospective, double-blind, randomised study. Patients were divided into two groups according to thiopental (Group T) or ketofol (Group K) administration. In anaesthesia induction, 4 mg kg-1 thiopental for Group T, 1 mg kg-1 ketamin + 1 mg kg-1 propofol (ketofol) for Group K were administered. Haemodynamic effects, BIS values, foetal parameters in the perioperative period and postoperative pain levels and morphine consumption were evaluated. RESULTS: There were no significant differences between groups with regard to demographic data. Heart rate values were lower in Group K than Group T and there were significant differences between values immediately after intubation and 15 min after intubation. There were no significant differences in systolic and diastolic blood pressures between the two groups. Apgar scores recorded at the 5th minute were higher in Group K, while there were no differences in the 1st minute scores between groups (p=0.01). Upon analyses of umbilical artery blood gas, pH values were higher in Group K (p=0.034). While pain scores were similar in groups, total morphine consumption for 24 hours was found to be higher in Group K (p=0.008). CONCLUSION: We believe that 1 mg kg-1 ketofol (1: 1), when used for anaesthesia induction of caesarean delivery, may be a good alternative to thiopental in terms of maternal and especially foetal effects; however, patients need to be followed closely for postoperative analgesic requirements.