article information

Anesthesiology and Pain Medicine: Vol.3, issue 1; 208-13
published online: June 30, 2013
article type: Research Article
received: December 14, 2012
accepted: February 9, 2013
DOI: https://doi.org/10.5812/aapm.9653
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Conscious Sedation and Analgesia in Colonoscopy: Ketamine/Propofol Combination has Superior Patient Satisfaction Versus Fentanyl/Propofol

authors:

avatar Mohammadreza Khajavi 1 , avatar Azra Emami 1 , avatar Farhad Etezadi ORCID 1 , * , avatar Saeid Safari 2 , avatar Alireza Sharifi 3 , avatar Reza Shariat Moharari 1

Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Department of Anesthesiology, Rasoul Akram Medical center, Iran University of Medical Sciences (IUMS), Tehran, Iran
Department of Gastroenterology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

how to cite: Khajavi M, Emami A, Etezadi F, Safari S, Sharifi A, et al. Conscious Sedation and Analgesia in Colonoscopy: Ketamine/Propofol Combination has Superior Patient Satisfaction Versus Fentanyl/Propofol. Anesth Pain Med. 2013;3(1): 208-13. https://doi.org/10.5812/aapm.9653.

Abstract

Background:

Colonoscopy is performed without preparing sedation in many countries. However, according to the current literature patients are more satisfied when appropriate sedation is prepared for them.

Objectives:

We hypothesize that propofol-ketamine may prepare more patient satisfaction compared to propofol-fentanyl combination.

Patients and Methods:

Sixty adult patients older than 18 with ASA physical status of I, II or III were enrolled in the present study after providing the informed consent. They were prospectively randomized into two equal groups: 1- Group PF: was scheduled to receive IV bolus dose of fentanyl 1g/kg and propofol 0.5mg/kg. 2- Group PK: was scheduled to receive IV bolus dose of ketamine 0.5mg/kg and propofol 0.5mg/kg. As a primary goal, patients satisfaction was assessed by the use a Likert five-item scoring system in the recovery. Comparisons of hemodynamic parameters (mean heart rate, mean systolic blood pressure, mean diastolic blood pressure), mean Spo2 values during the procedure and side effects such as nausea, vomiting, and psychological reactions during the recovery period were our secondary goals. Level of sedation during the colonoscopy was assessed with the Observers Assessment of Alertness/Sedation score (OAA/S).

Results:

Mean satisfaction scores in the group PK were significantly higher than the group PF (P = 0.005) while the level of sedation during the procedure was similar (P = 0.17). Hemodynamic parameters and SpO2 values were not significantly different (P > 0.05). Incidence of nausea and vomiting was the same in both groups.

Conclusions:

IV bolus injection of propofol-ketamine can lead to more patients satisfaction than the other protocols during colonoscopy.

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