The efficacy of combination of ketamine and propofol for sedation in colonoscopy

Abstract

Background : Colonoscopy is a procedure that cause considerable pain and discomfort to the patients.

Objective : To compare and evaluate the efficacy of combination of propofol and ketamine versus propofol alone for sedation in colonoscopic procedure. Methods : This was a prospective randomized double blinded controlled trial. 90 patients who underwent colonoscopy in Mahasarakham hospital were randomly assigned to K and N groups. 45 patients in group K received ketamine 0.5 mg/kg and propofol 1 mg/kg and 45 patients in group N received normal saline and propofol 1 mg/kg, the sedation maintained by using propofol intravenous infusion continuously. Blood pressure, heart rate, reapiratory rate and oxygen saturation were measured. Total propofol dose, procedural pain, adverse events, ease of endoscpy, recovery time, recovery score and endoscopist and patients satisfaction were also recorded.

Results : The incidence of hypotension and bradycardia were significantly lower in group K compared with group N (13.3% and 40%, respectively) (p=0.004). Mean total dose of propofol was significantly higher in group N compared with group K (9.97±3.15 mg/kg/hr and 7.41±2.43 mg/kg/hr, respectively) (p < 0.001). Recovery time was significant longer in group K compare with group N ( 10.91 min and 7.22 min, respectively) (p<0.001), but recovery score at 30 min post procedure were similar. Endoscopist satisfaction was more significant in the K group (p=0.010). There were no significant differences in the patient satisfaction and procedural pain.

Conclusions : The combination of ketamine and propofol for sedation in colonoscopy had significantly higher efficacy than the propofol alone because of more stable hemodynamic status, less propofol consumption, less adverse effects, endoscopist and patients were satisfied.

Keyword : ketamine, propofol, sedation, colonoscopy