The combination of ketamine and propofol, fentanyl and propofol has been used for anesthesia induction and total intravenous anesthesia. Advantages of using the combination have included hemodynamic stability intraoperatively and superior analgesia.

Forty patients (ASA physical status 1, 2) scheduled for cesarean section were randomized to either propofol-fentanyl (n=20) (P-F) or propofol-ketamine (n=20) (P-K) group. We checked to the cardiovascular effects of anesthetic induction, neonatal outcome, and maternal recovery time during cesarean section.

There were no significant differences in systolic and mean arterial pressure in both groups. Diastolic arterial pressure was increased significantly in both groups at intubation, but degree of increase was less in P-F group. The Apgar scores of the newborn and blood gas analysis of umbilical vein were not significantly different in both groups. Maternal recovery from anesthesia was significantly quicker in P-F group.

Propofol infusion coupled with fentanyl or ketamine would provide good anesthesia instead of inhalational anesthesia for cesarean section without significant adverse effects on both mother and fetus. However, recovery from anesthesia was faster and cardiovascular changes were less with P-F than P-K group.