Comparison of propofol/ketamine versus propofol/alfentanil for dilatation and curettage.

BACKGROUND AND OBJECTIVES: The use of propofol with an analgesic agent is probably the principal technique for the induction of anesthesia for dilatation and curettage (D&C) at the present time. We designed a randomized, double-blind study to compare the clinical efficacy of ketamine and alfentanil when combined with propofol for short-lasting anesthesia during D&C. METHODS: The study included 60 patients scheduled for D&C. Either alfentanil 10 microg/kg(-1) IV (Group A) or ketamine 0.5 mg/kg(-1) IV (Group K) were given to each patient with propofol 0.7 mg/kg(-1) IV for anesthesia induction. Surgeon and patient satisfaction, Aldrete score, Verbal Pain Scale rating, total propofol dose, orientation time, and adverse events such as bradycardia, hypotension, nausea, and vomiting were evaluated. RESULTS: In Group A orientation time was significantly shorter and propofol consumption significantly lower than in Group K. CONCLUSIONS: Both alfentanil/propofol and ketamine/propofol combinations provide reliable and effective hypnosis and analgesia; however, the ketamine/propofol combination leads to higher consumption of propofol and results in a longer orientation time than the alfentanil/propofol combination.