Consequences of Co-Administration of Propofol with Clonidine and Ketamine throughout Colon Cancer Surgery: A Randomized Trial



Nirvana Ahmed Elshalakany1, *
iD

1 Anesthesia and Intensive Care Unit, Faculty of Medicine, October 6 University, Cairo, Egypt


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Creative Commons License
© 2023 Nirvana Ahmed Elshalakany

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Anesthesia and Intensive Care Unit, Faculty of Medicine, October 6 University, Cairo, Egypt; Tel:+201001489004; E-mails: nirvanaahmed2022@gmail.com, nirvanaelshalakany@yahoo.com


Abstract

Objective:

Analgesic effects can be further augmented with the addition of clonidine and ketamine to the TIVA propofol, providing an even more effective anesthetic without compromising patient safety. This study aims to determine whether propofol infusion combined with clonidine and ketamine is more efficient in lowering the level of IL-8, preserving operation stability, and dropping post-operative pain and morphine intake.

Methods:

We conducted a study in which two groups of 60 patients were scheduled for colorectal cancer surgery. The treated group, (group T), received premedication with clonidine, intraoperative ketamine, and propofol for sedation. As a control group, a normal saline solution was administered to the group (Group C).

Results:

Group T reported lower levels of post-operative pain than the control group (P<0.05). This suggests that group T was more effective at reducing pain than the control group. A significant difference in mean arterial blood pressure was observed between groups (P<0.05). It is worth noting that there was no statistically significant difference in IL-8 levels between the two groups postoperatively (P>0.05). There was also a lower consumption of morphine (4.09±1.78) in group T postoperatively.

Conclusion:

It was found that TIVA using propofol with clonidine and ketamine was more effective than propofol infusion alone in maintaining hemodynamic stability, reducing postoperative pain, and decreasing morphine consumption over conventional propofol infusion. As a combination, propofol, clonidine, and ketamine provide and manage the pain of patients in a synergistic manner.

Clinical Trial:

Registration no.: The trial was registered under the clinical trials registery NCTU5536362 at ClinicalTrials.gov.

Keywords: Propofol, Clonidine, Ketamine, TIVA, IL-8, VAS, and Colon cancer.