Aim: The aim of the study was to compare the analgesic effects of ketamine over fentanyl combined with propofol in analgesia-based elective colonoscopy with purpose of patient safety and satisfaction. Methods: This is a double-blinded prospective randomized controlled trial. Ninety patients were included and randomized to either fentanyl-propofol (Group FP, n : 30), ketamine-propofol (Group KP, n : 30) or propofol-control group (Group C, n : 30). Group FP patients received fentanyl and propofol, Group KP received ketamine and propofol and Group C, propofol. In all groups, incremental doses of propofol were used to maintain a Ramsay sedation score (RSS) of 5. Respiratory depression and hemodynamic parameters were monitored for the first minute and every 5 min during endoscopy. Fifteen minutes after the procedure, the degree of pain was assessed using a visual analog scale (VAS), the quality of recovery according to the Aldrete score (ARS), complications during and after the procedure and additional doses of propofol were recorded. Results: Mean arterial pressure (MAP) at 5 and 30 min ( p < 0.05), heart rate (HR) at 15, 25 and 30 min ( p < 0.05) and peripheral oxygen saturation (SpO 2 ) at 30 min ( p < 0.05) were statistically significant for Group FP. Desaturation (* p = 0.033), and weakness (* p = 0.004) was also significant for Group FP at 20, 25 and 30 min ( p < 0.05). Pain was lower assessed for the Group KP according to the VAS (** p = 0.025). Conclusion: In analgesia-based colonoscopy, ketamine provides appropriate analgesia and less incidence of complications compared to fentanyl.

SUMMARY Persistent changes on chest x-ray and hypoxemia in arterial blood gas analyses have been described in several cases in novel CoV-19 virus (nCoV-19) patients. These changes are usually not expressed to a large extent. Our goal was not only to present a patient with comorbidities in whom residual pulmonary infiltrates remained with consequent hypoxemia after extubation, but also to show that these changes do not always correlate with the clinical condition. In summary, despite chest x-ray changes and hypoxemia, with appropriate respiratory physiotherapy, the patient had a satisfactory clinical status.

&lt;p&gt;&lt;strong&gt;Aim&lt;/strong&gt; &lt;br /&gt;To analyse demographic data, clinical symptoms and signs, laboratory data and comorbidities in patients with COVID-19 pneumonia admitted to the intensive care unit (ICU), mechanically ventilated with fatal outcome.&lt;br /&gt;&lt;strong&gt;Methods&lt;/strong&gt; &lt;br /&gt;Medical records of 92 patients were retrospectively analysed. Demographic data, clinical symptoms and comorbidities&lt;br /&gt;were collected on the day of hospital admission. Clinical signs and laboratory data were collected on the day of hospital admission (T1), on the day of starting non-invasive ventilation (T2), and on the day of starting invasive ventilation (T3).&lt;br /&gt;&lt;strong&gt;Results&lt;/strong&gt; &lt;br /&gt;Average age of the patients was 60.05 years. Patients over 50 years of age, 71 (77.1%) (p=0.000), and males, 62 (67.4%;&lt;br /&gt;p=0.001) were predominant. The most common patient symptoms were exhaustion, myalgia, dyspnoea and cough. Hyperthermia was recorded on the day of hospital admission. Tachycardia, hyperglycaemia, hypoxemia were recorded at all observed study times. The most common comorbidity was hypertension arterialis with a very strong correlation with fatal outcome, followed by diabetes mellitus and chronic heart disease that were moderately correlated with fatal outcome.&lt;br /&gt;&lt;strong&gt;Conclusion&lt;/strong&gt; &lt;br /&gt;The treatment of COVID-19 patients in ICU with mechanical ventilation has a high failure rate. Demographic data,&lt;br /&gt;clinical symptoms and signs as well as accompanying comorbidities can be a significant component in making decisions about diagnostic-therapeutic procedures.&lt;/p&gt;

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