Use of ketamine and propofol (ketofol) versus spinal anesthesia in hysteroscopy.

Abstract

Introduction: Hysteroscopy is the most common procedure for the study of endometrial pathologies and can be carried out using various anesthetic techniques such as general, spinal or sedation. Among anesthetic options, a technique that has recently gained attention in the literature is the combination of low doses of ketamine and propofol, known as ketofol, which induces a state of unconsciousness and analgesia, providing ideal conditions for short and minimally invasive surgical procedures. Objective: To compare two anesthetic techniques used in diagnostic hysteroscopy: sedoanalgesia with Ketofol and the technique with spinal anesthesia. Methodology: Double-blind randomized clinical trial in 24 female patients between 18 and 60 years of age undergoing diagnostic hysteroscopy. Results: This research included 24 female patients with ages between 26 and 61 years, with a mean of 43.25±8.5 years. The degree of sedation with Ketofol was adequate according to the Ramsay scale. The respiratory and hemodynamic behavior of the patients was stable in both groups. An increase in blood pressure was evident in one third of patients with sedation with ketofol. The level of satisfaction of surgeons and patients was adequate with both techniques. The time to discharge was shorter with Ketofol (3.42 1.5 hours) compared to spinal anesthesia (6.080.9 hours). Conclusion: The administration of sedoanalgesia with ketofol and spinal anesthesia were safe and feasible, with no significant differences found in the hemodynamic and respiratory stability profile. A faster discharge time was found in the ketofol group, which could improve the overall patient experience and decrease bed occupancy time.