Assessment of intubating conditions with propofol versus different concentrations of ketofol without muscle relaxation

Context Ketofol is a new combination formed by mixing ketamine and propofol. Little is known about its intubating characteristics, and therefore this study was conducted to evaluate and compare intubating conditions with propofol versus different concentrations of ketofol without muscle relaxation. Settings and design It was a randomized double-blind study. Patients and methods A total of 60 patients, with ASA I or II status, aged 18–45 years were randomized into three equal groups of 20 patients each. Propofol ‘P group’ received 2.5 mg/kg propofol, ketofol 2 ‘keto2 group’ received ketofol in concentration 1 : 2, and ketofol 4 ‘keto4 group’ received ketofol in concentration 1 : 4. Hemodynamic and intubating conditions in the form of jaw relaxation, vocal cord position, and intubating response were assessed. Results There was a significant difference in the intubation score (including jaw relaxation, vocal cord position, and intubation response) between the keto2 and keto4 groups when compared with the P group, with the most acceptable intubating condition observed in the keto4 group. Although a good intubation score was detected in the three groups, the grading of this score was different. Comparison of blood pressure and heart rate between groups showed no significant difference. Conclusion Good intubating conditions without using muscle relaxant are possible with 2.5 mg/kg propofol, ketofol in concentration 1: 2 and 1: 4, with the best intubating score in ketofol concentration 1: 4 group. In addition, more hemodynamic stability was achieved in both the ketofol groups.