Comparative Evaluation of Dexmedetomidine-Ketamine versus Ketamine-Propofol for Procedural Sedation during Dilatation and Curettage: A Prospective Randomized Double-Blind Study

ABSTRACT Background and Aims: Dilatation and curettage (D and C) is commonly performed as a daycare procedure under procedural sedation. We are comparing Dexmedetomidine-Ketamine (Dexket) versus Ketamine-Propofol (Ketofol) for sedation and analgesia in patients with abnormal uterine bleeding undergoing dilatation and curettage. Primary objective of the study was to compare time to onset of sedation and recovery. Secondary objectives included hemodynamics, time to achieve modified Aldrete score 9, number and time of additional doses of ketamine, and postoperative analgesia. Methods: In this randomized trial, 80 female patients, ASAI and II, 20 and 60 years, scheduled for elective D and C were analyzed. Group DK (n = 40) received inj dexmedetomidine (0.5 μg/kg) and ketamine (1 mg/kg) and group PK (n = 40) received inj ketamine (1mg/kg) and propofol (1 mg/kg). Statistical significance for continuous variables was assessed by unpaired t-test, whereas for categorical variables, Chi-square test was used. P value < 0.05 was considered as statistically significant. Results: Time to onset and recovery from sedation, time to achieve modified Aldrete score >9, and additional doses of ketamine were comparable in both the groups. Time to first additional ketamine dose was significantly longer in group DK. Patients in group PK had more pain postoperatively. There were no major adverse effects. Conclusion: Ketamine-dexmedetomidine is safe and effective alternative to ketamine-propofol for procedural sedation and analgesia in patients undergoing D and C with comparable onset and recovery times without any hemodynamic or respiratory adverse effects.