Methods: A prospective, randomized controlled trial was conducted on 100 ASA physical status I/II female patients aged 18- 50 years undergoing elective tubal sterilization. Patients were randomly assigned to either Group 1 (KF) receiving Ketofol (n=50) or Group 2 (PF) receiving propofol-fentanyl (n=50). The sedation protocol aimed for a Ramsay sedation score of 5-6, and hemodynamic parameters were monitored every 5 minutes during the procedure. The Visual Analogue Scale (VAS) was used to assess postoperative pain, and any adverse effects were recorded. Data analysis was performed using appropriate statistical tests, with significance set at p < 0.05.

Results: Demographic characteristics were comparable between the two groups. During the procedure, Group 1 (KF) showed significantly more stable hemodynamic parameters, with higher systolic BP (122.88 ± 6.85 mmHg vs. 111.30 ± 14.19 mmHg, p < 0.001) and diastolic BP (79.12 ± 6.46 mmHg vs. 70.26 ± 14.31 mmHg, p = 0.005) during incision. MAP and SpO2 were also more stable in Group 1. Sedation duration was longer in the KF group (17.72 ± 1.28 minutes) compared to PF (16.46 ± 0.81 minutes, p < 0.001), with a longer recovery time (8.74 ± 1.12 minutes vs. 6.34 ± 1.38 minutes, p < 0.001). VAS scores were significantly lower in Group 1 at all postoperative time points, indicating better pain control. Fewer patients in Group 1 required rescue analgesia (12% vs. 32%, p = 0.037). Adverse effects were more prevalent in Group 2, with a significantly higher incidence of hypotension (28% in PF vs. 0% in KF, p < 0.001).

Conclusion: The Ketofol combination demonstrated superior hemodynamic stability, prolonged sedation, better pain control, and fewer adverse effects compared to the propofol-fentanyl combination in patients undergoing tubal sterilization. Ketofol appears to be an effective and safe sedative alternative, providing improved perioperative outcomes and enhancing patient comfort.