Journal of Anesthesia and SurgeryJournal of Anesthesia and SurgeryJournal of Anesthesia and SurgeryJournal of Anesthesia and Surgery2377-1364Ommega Online PublishersNew Jersey, USA103610.15436/2377-1364.16.050Research ArticleKetamine-Propofol (Ketofol) as a Viable Alternative in a Septic Patient with Mediastinal Mass Requiring General Anesthesia for Endoscopic Retrograde Cholangio-PancreatographyKetamine-Propofol (Ketofol) as a Viable Alternative in a Septic Patient with Mediastinal Mass Requiring General Anesthesia for Endoscopic Retrograde Cholangio-PancreatographySurjyaprasad Upadhyay 1Consultant Anesthesiologist PVS Memorial Hospital Kaloor Kochi India 2Specialist Anesthesiologist NMC hospital DIP Dubai Investment Park Dubai Editor* E-mail: run77in@yahoo.com
The authors have declared that no competing interests exist.
20160209201632JAS-16-CR-103627072016270820162016Creative Commons Attribution LicenseThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. nbsp emsp amp emp Airway compromise and cardiovascular collapse can be anticipated in a patient with mediastinal mass due to aneurysm of ascending and arch of aorta during any stage of anesthesia Presence of septic shock limits the use of anesthetic agents The adverse effects of ketamine or propofol are dose dependent and tend to oppose each other cardiovascular effects The combination of ketamine and propofol may potentially balance each other rsquo s haemodynamic adverse effects and therefore offer a safer alternative for procedural sedation in critically ill An elderly emaciated lady diagnosed with acute cholecystitis and cholangitis in septic shock had fusiform aneurysm of ascending aorta and arch of aorta with mediastinal compression She underwent endoscopic retrograde cholangiopancreatogram ERCP under total intravenous anesthesia with a combination of propofol and ketamine which preserved spontaneous ventilation Haemodynamics were maintained with the judicious use of intravenous fluids and vasopressors 10