الفهرس 
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Abstract
This study was performed to assess haemodynamic changes and cost benefit ratio of fentanyl-propofol TIV A versus fentanyl-propofol-ketamine TrY A in 40 elderly patients submitted for lower limb orthopaedic surgery.
Patients were premedicated with 0.05 mglkg midazolam intramuscularly 45 min. before anaesthesia. A central venous line was inserted for CVP monitoring. Patients were randomly allocated into two groups 20 patients each.
Group ’:4” (Fentanyl- propofol).
Anaesthesia was induced by fentanyl 0.7 ).lglkg and propofol 1 % 11.5 mglkg bolus dose followed by tracheal intubation which was facilitated by a bolus dose of suxamethonium Imglkg. Maintenance of anaesthesia was achieved by propofol 1 % infusion using a syringe pump with the following regimen, 8mg /kg/h. for the first 20 minutes then decreased to 6 for the second 20 minutes and lastly changed into 4 mglkg/h till 10 min. before the end of the procedure with 100% oxygen supply and vecuronium in a bolus dose of 0.1 mglkg with supplementary doses when needed. Fentanyl in a dose of 0.5 mglkg was given after one hour to keep adequate analgesia. Reversal of the residual effect of muscle relax’ant was achieved by prostigmine 0.04 mglkg and atropine 0.02 mglkg.