 The anesthetic agent propofol can result in hypotension when used for induction of general anesthesia. Recent trials suggest that even a short duration of hypotension during induction of anesthesia can adversely affect organ function and overall outcome.1 To overcome the hypotensive effect of propofol, ketamine, which has sympathomimetic effects, has been combined with propofol to produce a mixture labeled ketofol, which has been used both for procedural sedation and induction of general anesthesia. Clinical trials have shown that ketofol can attenuate the hypotensive effects of propofol during procedural sedation or induction of general anesthesia in patients whose physical status is 1 or 2 according to the American Society of Anesthesiologists ASA 1-2, i.e., healthy patients or those with mild-moderate systemic illness.2,3 Clinically, it is important to demonstrate the efficacy of ketofol in attenuating hypotensive effects of propofol in sicker patients, i.e., patients with physical status ASA 3. The purpose of this study is to compare the hemodynamic effects of a standardized induction of general anesthesia with either propofol or ketofol in patients with physical status classification ASA 3. The study will be a double blinded, randomized controlled trial RCT with two arms of treatment groups. One arm will consist of induction of general anesthesia using a mixture of 1.5mgkg:0.75mgkg Propofolketamine ketofol and the induction dose will be 1.5mgkg of propfol and 0.75mgkg of ketamine; the second arm will consist of induction of general anesthesia using propofol 2mgkg. The primary outcome of the intervention will consist of hemodynamic changes during the first 30 minutes after induction of general anesthesia. 