Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 32 297 2014 09 23 Comparing the Effects of Low Doses of Propofol, Ketamine and Combination of Propofol-Ketamine in Prevention of Post-Extubation Coughing and Laryngospasm Comparing the Effects of Low Doses of Propofol, Ketamine and Combination of Propofol-Ketamine in Prevention of Post-Extubation Coughing and Laryngospasm 1299 1309 14409 FA Azim Honarmand Associate Professor, Department of Anesthesiology and Critical Care, School of Medicine AND Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Mehdi Khazaei Student of Medicine, Anesthesiology and Critical Care Research Center AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Mohammadreza Safavi Homami Associate Professor, Department of Anesthesiology and Critical Care, School of Medicine AND Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-8975-7661 Journal Article 2014 08 11 Background: One of the most common complications in patients awakening from general anesthesia is post-extubation coughing. Laryngospasm, as a complication too, can result in severe outcomes. This study was conducted to compare the effect of small doses of propofol, ketamine and their combination on incidence and severity of post-extubation coughing and laryngospasm.Methods: Patients, who were scheduled to undergo operations under general anesthesia, were randomly divided in 4 groups of 40. Routine anesthesia was performed. Patients received 0.25 mg/kg propofol, 0.25 mg/kg ketamine, 0.25 mg/kg propofol, and 0.25 mg/kg ketamine and 0.1 ml/kg normal saline in propofol, ketamine, propofol-ketamine and control groups, respectively. Drugs were administered before extubation. Coughing and laryngospasm was recorded and graded at previously defined times during emergence from anesthesia.Findings: The incidence of coughing was 23 cases (57.5%) in propofol, 28 cases (70%) in ketamin, 11 cases (27.5%) in propofol-ketamine, and 33 cases (82.5%) in control group. The differences between the propofol-ketamine and other 3 groups and between the propofol and control groups were significant (P < 0.050). But, no significant differences were noted between the propofol and ketamine groups (P = 0.356) and between the ketamine and control groups (P = 0.121). Comparing the incidence of sever coughing (grade 3), the differences between the propofol-ketamine (no patients) and propofol (4 patients) (P = 0.040) and control (7 patients) (P = 0.006) groups were significant. No significant difference was noted between the groups in frequency of laryngospasm (P < 0.050).Conclusion: It could be concluded that the combination of low-dose propofol and ketamine could decrease the incidence and the severity of post-extubation coughing. Propofol could decrease this incidence, too (although less than combination). Background: One of the most common complications in patients awakening from general anesthesia is post-extubation coughing. Laryngospasm, as a complication too, can result in severe outcomes. This study was conducted to compare the effect of small doses of propofol, ketamine and their combination on incidence and severity of post-extubation coughing and laryngospasm.Methods: Patients, who were scheduled to undergo operations under general anesthesia, were randomly divided in 4 groups of 40. Routine anesthesia was performed. Patients received 0.25 mg/kg propofol, 0.25 mg/kg ketamine, 0.25 mg/kg propofol, and 0.25 mg/kg ketamine and 0.1 ml/kg normal saline in propofol, ketamine, propofol-ketamine and control groups, respectively. Drugs were administered before extubation. Coughing and laryngospasm was recorded and graded at previously defined times during emergence from anesthesia.Findings: The incidence of coughing was 23 cases (57.5%) in propofol, 28 cases (70%) in ketamin, 11 cases (27.5%) in propofol-ketamine, and 33 cases (82.5%) in control group. The differences between the propofol-ketamine and other 3 groups and between the propofol and control groups were significant (P < 0.050). But, no significant differences were noted between the propofol and ketamine groups (P = 0.356) and between the ketamine and control groups (P = 0.121). Comparing the incidence of sever coughing (grade 3), the differences between the propofol-ketamine (no patients) and propofol (4 patients) (P = 0.040) and control (7 patients) (P = 0.006) groups were significant. No significant difference was noted between the groups in frequency of laryngospasm (P < 0.050).Conclusion: It could be concluded that the combination of low-dose propofol and ketamine could decrease the incidence and the severity of post-extubation coughing. Propofol could decrease this incidence, too (although less than combination). https://jims.mui.ac.ir/article_14409_746206d63610c80c08bdf440226b462a.pdf