Available online at www.medicinescience.org ORIGINAL RESEARCH Medicine Science 2020;9(1):21-5 The effects of anaesthesia induction with propofol or ketofol on cerebral oxygenation in patients above 60 years of age Harun Tolga Duran, Ersin Koksal, Yasemin Burcu Ustun, Sezgin Bilgin, Fatih Ozkan Ondokuz Mayıs University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Samsun, Turkey Received 29 May 2019; Accepted 10 September 2019 Available online 05.02.2020 with doi: 10.5455/medscience.2019.08.9128 Abstract Side effects such as hypotension and cerebral perfusion disorder may be encountered after anaesthesia induction, especially in elderly patients. Some studies have attempt- ed to determine whether hypotension during induction and associated organ perfusion disorders can be prevented when propofol is used in combination with ketamine. However, no study has come to light investigating the effects of ketamine added to propofol on cerebral oximetry. The present study aimed to compare the effects of anaesthesia induction with propofol or propofol+ketamine (ketofol) on haemodynamic changes and cerebral oximetry in elderly patients undergoing anaesthesia induction. A total of 40 patients were randomly divided into two groups. Cerebral oximetry sensors were placed in the right and left of the frontal region. Patients in Group P were treated with 1.5 mg/kg propofol IV induction and patients in Group K were treated with the 0.2 ml/kg ketofol IV. The patients in both groups received 0.5 mg/kg lidocaine, 0.6 mg/kg rocuronium and a 0.1 mcg/kg/min infusion of remifentanil. Heart rate (HR), systolic, diastolic and mean arterial pressure (SBP, DBP, MAP) and cerebral oxygen saturation (RSO 2 ) values before and 1, 3, 5, 10, 30 and 60 minutes after induction were recorded.SBP, DBP and MAP values were signifcantly lower in the propofol group at 1, 3 and 5 minutes after induction (p < 0.05). The right-side RSO 2 values were signifcantly lower at 3 and 5 minutes after induction in the propofol group compared to the ketofol group and the left-side RSO 2 values were similarly signifcantly lower after 1, 3 and 5 minutes (p < 0.05). Ketofol used in anaesthesia induction has less effect than propofol on mean arterial pressure and cerebral oxygen saturation values. Therefore, ketofol appears to be a good choice for use in anaesthesia induction in elderly patients. Keywords: Propofol, ketamine, cerebral oximeter, elderly patients Medicine Science International Medical Journal 21 Introduction Elderly patients’ sensitivity to drugs used in anaesthesia induction is increased [1]. As a result, hypotension and consequently decreased brain blood fow may occur after anaesthesia induction [2]. This reduction in brain blood fow becomes more evident by the fact that propofol causes more myocardial depression and hypotension, especially in elderly patients.[3,4] Ketamine activates the sympathetic nervous system to increase heart rate and blood pressure, and consequently elevation of cerebral blood fow[5-7]. Cerebral oxygen saturation values are affected by hypotension and the decreased cerebral blood fow that may follow the hypotension. Propofol reportedly causes a temporary decrease in cerebral oxygen saturation in both young and old patients with a decrease in the mean arterial pressure following anaesthesia induction [4]. Undesired haemodynamic side effects can be reduced with the use of propofol and ketamine together [8-13]. However, to the best of our knowledge, there has been no study investigating how the combined use of propofol and ketamine affects cerebral oxygenation in elderly patients. Therefore, the aim of the present study was to compare the effects of propofol or ketofol (ketamine+propofol) on haemodynamic changes and brain oxygenation in anaesthesia induction in elderly patients. Materials and Method The study was carried out between January 2016 and June 2016 in the hospital operating theatre, after obtaining the approval of the ethics committee of Ondokuz Mayıs University (Year: 2015 Number: B.30.2.0DM.0.20.08/2120). All patients were informed about the study before the procedure and their voluntary informed consent was obtained. A total of 40 patients classifed as ASA 1 or 2 and above 60 years of age who underwent elective laparotomy were included in our study. Patients with cerebrovascular disease, coronary artery *Coresponding Author: Sezgin Bilgin,.Ondokuz Mayıs University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Samsun, Turkey E-mail: sezgin.bilgin@omu.edu.tr