Comparative impact of ketofol vs propofol on postoperative cognitive, functional and pain outcomes in surgical patients
Bibliographic record
Abstract
Postoperative cognitive dysfunction is an emerging condition associated with surgery under general anesthesia, especially in elderly patients, with major detrimental health effects. To optimize anesthetic drug use, the study aimed to evaluate the effects of ketofol (ketamine-propofol combination) on postoperative cognition, pain, and functional recovery in comparison with propofol. In this prospective, observational, and comparative study, 52 patients were enrolled and divided into two groups based on the anesthetic agent employed for induction: either ketofol (Group KP) or propofol (Group P). Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) preoperatively and at 2, 24 and 48 hours post-surgery. Functional recovery was examined using the Modified Aldrete Score (MAS), and pain levels were recorded at the same time intervals using the Visual Analog Scale (VAS). Hemodynamics were also monitored during the procedure. Data were initially analyzed using the Mann-Whitney U Test and student’s t-test; subsequently, Linear Mixed Models (LMM) were employed to adjust for potential covariates. MoCA scores at 24 and 48 hours were significantly higher in the ketofol group (p = 0.001 and p = 0.002), but MMSE scores showed no statistical difference. Pain scores were significantly lower in the ketofol group at 2, 24, and 48 hours (p = 0.010, p = 0.001, and p = 0.0001). However, LMM did not confirm these findings as statistically significant. Ketofol demonstrated better hemodynamic stability, especially in terms of systolic and diastolic blood pressure and SpO2 readings. Although Ketofol was associated with better postoperative cognitive preservation, pain control, and hemodynamic stability compared to propofol in the unadjusted analyses, adjusted models indicated that these differences could be influenced by confounders such as age and gender, necessitating further investigation into its clinical use.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".