The combinatorial use of propofol-fentanyl-ketamine for sedoanalgesia in patients undergoing urological procedures

Abdelkarim S. Aloweidi; Sami A. Abu-Halaweh; Ghazi M. Al-Edwan; Saddam H. AL Demour; Laith T. Abu Mahfuz; Osama N. Noubani; Mohammad M. Al Rwaidi; Isam K. Bsisu; Mohammad M. Abufaraj

doi:10.15537/smj.2021.42.6.20210071

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Table 1

- A comparison between the 2 groups in terms of patients’ demographics.

Characteristics	GA	PFK	P-value
Characteristics	(n=100)	(n=101)	P-value
Age, years [IQR]	51 [41.3- 66.8]	53 [42.5- 64]	0.758
Gender
Male	80 (80)	81 (80.2)	0.972
Female	20 (20)	20 (19.8)	0.972
Smoking
Smoker	55 (55)	45 (44.5)
Non-smoker	4 (4)	3 (3.0)	0.263
Ex-smoker	41 (41)	53 (52.5)
Weight, kilograms [IQR]	81 [73-90]	80 [70-90]	0.663
Hypertension,	33 (33)	40 (39.6)	0.33
Diabetes mellitus	22 (22)	26 (25.7)	0.534
Iischemic heart disease	8 (8)	11 (10.9)	0.484
Chronic kidney disease	10 (10)	6 (5.9)	0.288

Values are presented as numbers and percentages (%). Mann-Whitney U test, Chi-squared test (χ² test), and Fisher’s exact test were used to investigate the presence of significant difference between the 2 independent groups. GA: general anaesthesia, IQR: interquartile range, PFK: propofol-fentanyl-ketamine

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Table 2

- A comparison between the two groups in terms of intraoperative adverse events, post-operative complications, operative duration, and patients’ satisfaction.

Characteristics	GA	PFK	P-value
Characteristics	(n=100)	(n=101)	P-value
Duration of induction, minutes [IQR]	5 [4-7]	2 [2-4]	<0.001
Duration of surgery, minutes [IQR]	30 [15.25-40]	15 [15-25]	<0.001
Duration of termination of anaesthesia, minutes [IQR]	7 [5-9.75]	1 [0-3]	<0.001
Hypotension	37 (37)	1 (1.0)	<0.001
Use of vasopressor	30 (30)	0 (0)	<0.001
Transient O₂ desaturation	1 (1)	6 (6.0)	0.212
Airway management required	3 (3)	25 (24.8)	<0.001
Penile erection	3 (3)	1 (1.0)	0.369
Postoperative data
Nausea and vomiting	2 (2)	4 (4.0)
Nausea without vomiting	5 (5)	2 (2.0)	0.374
Neither nausea nor vomiting	93 (93)	95 (94.0)
Hallucination	5 (5)	8 (7.9)	0.400
Respiratory depression	3 (3)	5 (5.0)	0.721
Remembering intraoperative events	10 (10)	15 (14.9)	0.297
Pain score, median [IQR]	1 [1-2]	1 [1-2]	0.197
Post-operative paracetamol	18 (18)	14 (13.9)	0.597
Post-operative morphine	1 (1)	2 (2.0)	0.597
Median time to regain consciousness, minutes (IQR)	10 [10-20]	15 [10-20]	0.322
Liked the experience	83 (83)	74 (73.3)	0.095
Satisfaction score, median (IQR)	5 [4-5]	3 [3-4]	<0.001

Values are presented as numbers and percentages (%). Mann–Whitney U test, Chi-squared test (χ² test) and Fisher’s exact test were used to investigate the presence of significant difference between the 2 independent groups. *GA: general anaesthesia, IQR interquartile range, PFK: propofol-fentanyl-ketamine, Bold numbers indicate statistically significant correlations.

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Table 3

- Univariable and multivariable logistic regression for predicting hypotension in our cohort.

Variable	Univariable			Multivariable
	OR	95% CI	P-value
	OR	95% CI	P-value	OR	95% CI	P-value
Age	1.04	1.01-1.06	0.004	1.05	1.02-1.08	0.004
gender (ref. male)	0.42	0.14-1.25	0.117	-	-	-
Weight	1.00	0.97-1.02	0.734	-	-	-
Duration of induction	1.27	1.12-1.45	<0.001	1.05	0.91-1.23	0.436
Type of anaesthesia (ref. GA)	58.73	7.86-438.8	<0.001	65.78	8.17-529.5	<0.001