Comparison of the combination of Propofol and Tramadol vs Propofol and Ketamine for intracavitary brachytherapy in cervical cancer

Abstract

Background: Numerous combinations of drugs are used for sedation in intracavitary brachytherapy in cervical cancer. Objective of the study was to compare the combination of Propofol and Tramadol vs Propofol and Ketamine for intracavitary brachytherapy in cervical cancer. Methods: We performed a single-center randomized double blind controlled study in the Department of Anesthesiology, Dr. B. Borooah Cancer Institute, a tertiary cancer care center, Guwahati, Assam, India with 54 patients over a period of 3 months between December 2019 to February 2020. Variables like age, American Society of Anesthesiology score, Total time under sedation, Total dose of combination sedatives, Number of top up doses of combination sedatives, Pulse variation in study patients, Blood Pressure variation in study patients, Time taken to awakening in minutes by study patients, Time required for recovery in minutes by study patients and need for any emergent intervention were captured from study population. The study protocol was performed in accordance with the principles of the declaration of Helsinki and after approval by the Institutional ethical review board. A written informed consent was obtained from the eligible patients. Patients with history of allergy to any of the agents, eggs, soy were not included in the study. Also patients were excluded if they had ASA status greater than 3, had known hypersensitivity to either of the study products or were hemodynamically unstable. Eligible participants were randomized into either Propofol/Ketamine or Propofol/Tramadol group in a fixed 1:1 allocation from blocks of 4. The data was entered; tabulated and statistical analysis was performed by using Statistical Package for the Social Sciences (SPSS 24.0) and Graph Pad Prism Version 5. A value of p<0.05 was considered significant. Results: The mean age and median the study populations was 53.57 and 54.5 years (range, 26-74 years), respectively. Total dose of Propofol/Tramadol group and Propofol/Ketamine group was 21.035mL and 17.57 mL respectively. Total time required for awakening by patients receiving Propofol/Tramadol group and Propofol/Ketamine group was 2.13 mins and 4.45 mins, respectively. Conclusion: Propofol/Ketamine anesthesia in patients undergoing intracavitary brachytherapy in cervical cancer provided stable hemodynamic stability and sedation as compared to propofol/tramadol anesthesia.