{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T02:00:44Z","timestamp":1785117644410,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005375","name":"\u201cBiomedical and Photonics Research Platform for the Creation of Innovative Products (BioPhoT)\u201d, project","doi-asserted-by":"publisher","award":["OSI_PIP_BioPhoT-2025\/1-0076"],"award-info":[{"award-number":["OSI_PIP_BioPhoT-2025\/1-0076"]}],"id":[{"id":"10.13039\/501100005375","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Hemodynamic instability during anesthesia induction and endotracheal intubation remains a clinically important concern. Low-dose ketamine and intravenous lidocaine may provide complementary effects that improve cardiovascular stability and peripheral perfusion. This pilot study evaluated effects of adding ketamine and lidocaine to a propofol-based induction regimen using mean arterial pressure (MAP) and perfusion index (PI) as monitoring parameters. Materials and Methods: In this prospective observational pilot study, 30 adult patients undergoing elective surgery requiring general anesthesia and endotracheal intubation were allocated to either a standard induction regimen (Group 1: propofol 2 mg\/kg and fentanyl 2 \u03bcg\/kg) or an adjunctive regimen (Group 2: propofol 2 mg\/kg, ketamine 0.4 mg\/kg, lidocaine 1 mg\/kg, and fentanyl 1 \u03bcg\/kg). Hemodynamic variables and PI were recorded at baseline, after induction, and after intubation. Postoperative sore throat and cough-reflex responses were also assessed. Results: No significant differences between-groups were observed in heart rate, systolic blood pressure, diastolic blood pressure, MAP, or oxygen saturation at any time point. However, MAP decreased significantly within Group 1 after induction (94.9 \u00b1 10.1 vs. 76.9 \u00b1 13.8 mmHg, p &lt; 0.001) and remained lower after intubation (p = 0.001), whereas no significant MAP changes occurred within Group 2. PI increased in both groups but was significantly higher in Group 2 after induction (5.35 \u00b1 2.34 vs. 3.46 \u00b1 2.90, p = 0.043) and after intubation (7.02 \u00b1 2.89 vs. 4.71 \u00b1 2.22, p = 0.020). Postoperative sore throat scores were lower in Group 2 (0.53 \u00b1 0.91 vs. 1.67 \u00b1 1.76, p = 0.035), and cough-reflex scores were also reduced (p = 0.024). Conclusions: The addition of low-dose ketamine and intravenous lidocaine to propofol-based induction was associated with higher perfusion index values and reduced airway-related adverse effects. No statistically significant between-group difference in mean arterial pressure (MAP) was detected. These findings are hypothesis-generating and warrant confirmation in larger randomized trials.<\/jats:p>","DOI":"10.3390\/medicina62081443","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:26:23Z","timestamp":1785115583000},"page":"1443","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perfusion Index and Hemodynamic Responses During Propofol Induction with Fentanyl or Ketamine\u2013Lidocaine Adjuncts: A Prospective Randomized Pilot Clinical Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1533-5746","authenticated-orcid":false,"given":"Mara","family":"Klibus","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care and Clinical Simulations, Riga Stradi\u0146\u0161 University, 1007 Riga, Latvia"},{"name":"Department of Anaesthesiology, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh Prabhakar","family":"Bhavsar","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care Medicine, South Jutland University Hospitals, 6200 Aabenraa, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jekaterina","family":"Jagodzinska Peskova","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care Medicine, South Jutland University Hospitals, 6200 Aabenraa, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklavs","family":"Nemme","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care and Clinical Simulations, Riga Stradi\u0146\u0161 University, 1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Duboka","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liga","family":"Gabrane","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olegs","family":"Sabelnikovs","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care and Clinical Simulations, Riga Stradi\u0146\u0161 University, 1007 Riga, Latvia"},{"name":"Department of Anaesthesiology, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"ref_1","first-page":"469","article-title":"Is anesthesia dangerous?","volume":"108","author":"Gottschalk","year":"2011","journal-title":"Dtsch. 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