Efficacy of Sedation for Colonoscopy, A Comparison between Propofol and Ketamine Combination (Ketofol) Versus Propofol and Fentanyl Combination (Fenofol)
Keywords:
Ketofo, Fenofol, Ketamine, Propofol, Fentanyl, Colonoscopy, SedationAbstract
Background: Colonoscopy requires anesthesia for patients’ comfort and reduction of abdominal pain.Objectives: To compare the efficacy of ketofol versus fenofol in anesthesia for colonoscopy.Methods: This study was a randomized, double-blind controlled trial. Sixty-four patients aged 18-85 years who underwent colonoscopy in Ubonratchathani Cancer Hospital were randomly assigned to ketofol and fenofol groups. The thirty-two patients in the ketofol group initially received an intravenous bolus injection of ketamine 0.5 mg/ kg and propofol 1 mg/ kg whereas the thirty-two patients in the fenofol group received an intravenous bolus injection of fentanyl 1 mcg/ kg and propofol 1 mg/ kg. Afterwards, whenever a patient’s Ramsay Sedation Score became less than 5, he or she received another injection of 5 ml of the combination used in his or her group. Blood pressure, heart rate, oxygen saturation, Ramsay Sedation Score, total dose of the drug, duration of the procedure, recovery time, postoperative pain, patients satisfaction, and adverse events were recorded.Results: Patients in the ketofol group had significantly higher systolic blood pressure (132±13.48 mmHg), and mean arterial blood pressure (93.03±10.32 mmHg) compared to the systolic blood pressure (124±15.83 mmHg), and mean arterial blood pressure (86.75±11.51 mmHg) of the fenofol group (p=0.025 and p=0.025 respectively). The average Ramsay Sedation Score in the ketofol group was 5.75±0.44, significantly higher than fenofol group, which was 5.38±0.66, (p=0.01). There was a significantly higher number of patients who required airway maneuvers in the fenofol group (10 patients (31.2%)) compared to the ketofol group (3 patients (9.4%)), (p=0.045). Hallucination and nightmares were significantly more common in the ketofol group (4 patients (12.5%)) compared to the fenofol group [None], (p=0.039).Conclusions: Ketofol and fenofol were both effective options for sedation in colonoscopy. The ketofol group required less airway management, but caused more hallucination and nightmares
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