Introduction
death, shock, organ failure, hypotension, Anesthesia-induced hypotension
SHOCK
Anesthesia-induced hypotension is associated with serious organ failure and death [Patients undergoing emergency laparotomy are usually hemodynamically compromised and prone to post-induction hypotension; furthermore, these patients are usually at high risk of aspiration of gastric contents and require rapid-sequence induction of anesthesia and optimum intubating conditions.Thus, induction of anesthesia for emergency laparotomy requires meticulous balance between achieving adequate hypnosis and maintenance of stable hemodynamics. Propofol is the commonest hypnotic agent worldwide. However, it is usually associated with hypotension especially in compromised patients. Ketamine produces dissociative anesthesia and sympathetic stimulation which provides more stable hemodynamic profile; however, ketamine is not widely used as a routine hypnotic [Nevertheless, ketamine still has a role in induction of anesthesia in patients with shock and during procedural sedation [Propofol/ketamine admixture (ketofol) was introduced in anesthetic practice aiming to counterbalance the side effects of the two drugs and to provide, consequently, the desired balance between adequate hypnosis and hemodynamic stability [The aim of this study is to compare two ratios of propofol and ketamine, namely 1:1 and 1:3 ratios, in rapid-sequence induction of anesthesia for emergency laparotomy regarding the vasopressor consumption, hemodynamic profile, adequacy of hypnosis and intubation conditions.