The effect of propofol and propofol/ketamine induction on hemodynamics and electrocardiography in patients having coronary arterial diseases

Introduction and Aim: The selection of the anaesthetic agent for anasesthesia induction to maintain cardiovascular stability in patients undergoing a coronary artery surgery is important. The patients with coronary artery diseases have a tendency to arhythmia in perioperative period. As the adverse effects of ketamine and propofol on heart rate and arterial pressure maintain a fixed cardiac stability, their combinational use may be more effective than their separate use, in the patients with coronary artery. The aim of our study is to search the effects of combination of propofol and ketamine on the hemodynamic response and ECG alterations in patients with coronary artery diseases.Material-Method: The patients were separated into two groups as propofol (Group P n=31) group and ketamine-propofol (Group KP n=32) group. In the propofol group, 10 mg/mL was prepared in 20 mL syringe and in the ketamine-propofol group ketamine and propofol combination was prepared (concentrations: 10 mg/ml ketamine and 10 mg/mL propofol). The agents were used in 2 mg/kg for both groups. Then, 3-5 mcg/kg iv fentanyl and 0,1 mg/kg iv vecuronium bromine was performed. The patient?s lungs were manually oxygenised by facial mask with O2 100 % until full muscle relaxation. ECG records were recorded before anaesthesia induction (T0), 2 minute after ketamine propofol injection (T1), before intubation (T2), 30 seconds after intubation (T3), 1 minute after intubation (T4), and 5 minutes after intubation (T5).Results: Patients were similar in age, weight, height, and gender. There was no statistically difference in terms of heart rate, SAP, DAP, MAP, QT interval and Tp interval values between groups (p>0.05).Within the group evaluation, the SAP, DAP, MAP values significantly decreased compared with their first values (p<0.05).Within the group evaluation, while the QTc interval significantly decreased after the induction in Group P, there was no difference in KP group (p>0.05). The QTc interval significantly increased in all periods after intubation for both groups (p<0.05). There was no statistically difference in terms of Tp interval (p>0.05).Conclusion: While the ketamine-propofol combination has no effect on QTc interval after induction, it has prolonged the QTc interval like propofol. However, as there was no alteration in the Tp interval in all periods and the hemodynamic response to intubation was repressed, we are of the opinion that this combination can be used in the anasesthesia induction safely.