Comparison of the Effect of Induction of General Anesthesia with Propofol Vs Ketamine + Midazolam on Perfusion Index in Cardiac Patients Undergoing Non-Cardiac Surgery: General Anesthesia with Propofol Vs Ketamine + Midazolam on Perfusion Index in Cardiac Patients

Muhammad Ashraf Khan; Farrukh Afzal; Sohaib Yousaf; Sheeza Bashir; Sundas Aslam; Majid Farooq; Hafiz Muhammad Umer Mehran

doi:10.54393/pjhs.v7i5.3654

Authors

Muhammad Ashraf Khan Department of Anesthesia, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
Farrukh Afzal Department of Anesthesia, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
Sohaib Yousaf Department of Anesthesia, Fatima Jinnah Medical University, Sir Gangaram Hospital, Lahore, Pakistan
Sheeza Bashir Department of Anesthesia, King Edward Medical University, Lady Willingdon Hospital, Lahore, Pakistan
Sundas Aslam Department of Anesthesia, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
Majid Farooq Department of Anesthesia, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
Hafiz Muhammad Umer Mehran Department of Anesthesia, Midland Regional Hospital Tullamore, Ireland

DOI:

https://doi.org/10.54393/pjhs.v7i5.3654

Keywords:

Cardiac Patients, Ketamine, Midazolam, Propofol, Perfusion Index

Abstract

Hemodynamic stability is a critical concern in cardiac patients. The choice of induction agent significantly influences cardiac output and tissue perfusion. Objectives: To compare the effect of induction with ketamine and midazolam vs. propofol on perfusion index in cardiac patients under general anesthesia. Methods: This quasi-experimental study was done from January 2024 to June 2024 at the Department of Anesthesia, Mayo Hospital, Lahore. Total 146 patients undergoing non-cardiac surgery were included after taking written consent. Patients were assigned to two equal Groups: M (midazolam and ketamine) or Group P (propofol). Outcome parameters, including SBP, MAP, and perfusion index, were recorded pre- and post-induction. Data were collected using a proforma and analyzed with SPSS-26. Results: Post-induction, mean SBP in Group M was higher, 126.02 ± 12.58 mmHg, vs Group P, 120.61 ± 13.09 mmHg, p-value=0.01. Post-induction mean MAP in Group M and P calculated was 74.17 ± 10.06 mmHg, and 71.02 ± 9.82 mmHg, p-value=0.05. Post-induction PI in Group M was also higher, 1.88 ± 0.40, vs Group P, 1.69 ± 0.28, p-value=0.001. Conclusions: Findings of the current study suggest that induction with ketamine and midazolam may lead to increased post-induction mean perfusion index as compared to propofol in cardiac patients. Therefore, assists in maintaining peripheral perfusion in cardiac patients, which could be beneficial for postoperative recovery and minimizing complications.

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