Comparison of Ketamine-Propofol and Ketamine-Thiopental on Bispectral Index Values during Monitored Anesthesia Care (MAC) in Minor Traumatic Orthopedic Surgery; A Randomized, Double-Blind, Clinical Trial

Objective: to compare the effects of ketamine-propofol and ketamine-thiopental on bispectral index values during monitored anesthesia care in minor orthopedic surgeries. methods: this randomized double-blind clinical trial was performed on 90 patients undergoing minor orthopedic surgeries. participants were randomly allocated to either groups of propofol or thiopental. bispectral index (bis), non-invasive arterial blood pressure, spo2, and electrocardiogram were monitored every 5 minutes. patients in propofol group received a bolus dose of 0.5 mg/kg ketamine, plus 0.5 mg/kg propofol. in thiopental group, patients received a bolus dose of 0.5 mg/kg ketamine, plus 50-75 mg thiopental. after the surgery, recovery duration, patients’ pain score (vas) and any intra-operative recall or awareness were recorded. statistical analysis was performed using spss version 19.0 results: bis was lower in ketamin-propofol group (p<0.001). mean arterial blood pressure, heart rate and o2 saturation showed a significant difference between two groups (p<0.001), which were lower in ketamin– propofol group. vas score was higher in ketamin-thiopental group (p<0.001). both groups were similar in intra-operative recall/awareness. conclusion: ketamine-propofol combination deliver a better control over monitored anesthesia during surgery, providing lower bis, higher o2 saturation and lower heart rate and arterial blood pressure in patients undergoing minor traumatic orthopedic surgeries.