PROPOFOL-KETAMINE COMBINATION HAS SHORTER RECOVERY TIMES WITH SIMILAR HEMODYNAMICS COMPARED TO PROPOFOL ALONE IN UPPER GASTROINTESTINAL ENDO- SCOPY IN ADULTS. A RANDOMIZED TRIAL

Background and aim: Gastrointestinal endoscopy (GIE) is a common procedure for many gastrointestinal disorders. Propofol is a widely used agent with rapid onset of action in GIE, however it may cause cardiovascular and respiratory depression in a dose dependent manner. These untoward effects may be reduced/eliminated with addition of ketamine. In this study, we aimed to compare propofol vs. propofol-ketamine combination in respect of hemodynamics and recovery times for upper GIE sedation. Material and method: This prospective randomized study was performed on 100 patients who underwent upper GIE intervention. Patients were randomized to propofol (n:50) (P) or propofol-ketamine (n: 50) (PK) groups. All patients received study drugs till ramsay sedation scale of patients titrated to 3-4. The heart rate, mean arterial blood pressure and peripheral O2 saturation were recorded. Total drug dosage, endoscopy time, spontaneous eye opening and response to verbal command time, patient and doctor satisfaction scores were also recorded. Results: Demographic data, hemodynamic data and endoscopy time were found similar in the two groups (p>0.05 for all comparisons). Spontaneous eye opening and response to verbal commands time were shorter in PK group (p=0.03, p=0.01 respectively). Heart rate, mean arterial pressure, periphreal oxygen saturation were similar between groups in all time intervals (p>0.05 for all comparisons). Side effects including respiratory depression, bradycardia, hypotension, nausea, vomiting and secretion increase were found to be similar in both groups (p>0.05 for all comparisons). Patients’ and endoscopists’ satisfaction scores were also similar in both groups (p>0.05 for all comparisons). Conclusion: Propofol ketamine combination is associated with a shorter mean recovery time than propofol, with similar hemodynamic stability and satisfaction scores, without any important side effects in GIE interventions.

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