A comparison of different proportions of a ketamine-propofol mixture administered in a single injection for patients undergoing colonoscopy

Abstract

IntroductionIn this study, we aimed to determine the appropriate proportion of ketamine-propofol (ketofol), which was prepared in two different proportions for colonoscopy procedures.Material and methodsThis is a prospective and randomized trial. Group 1 was administered a mixture of 100 mg ketamine and 200 mg propofol. Group 2 was administered 50 mg ketamine and 200 mg propofol. Additional doses of 0.5 mg/kg bolus propofol without ketamine were administered to both groups to stabilize the bispectral index at 70–80 and with a Ramsey sedation score of 3–4. The pulse rate, mean arterial pressure (MAP), peripheral oxygen saturation values, colonoscopy period, adverse events, recovery time, discharge time, additional propofol doses, total propofol doses, colonoscopist and patient satisfaction were recorded.ResultsIn group 2, the 1 min MAP mean was significantly lower than the initial, 10, 15 and 20 min MAP means (p = 0.014, p = 0.002). The 20 min PR mean of group 2 was statistically significantly higher than group 1 (p = 0.045). The 15 min PR mean of group 2 was significantly lower than the initial and the 1 min PR means (p = 0.023, p = 0.006). The total propofol dose mean of group 2 was significantly higher than group 1 (p = 0.0001). The presence of adverse events in group 2 was significantly lower than that in group 1 (p = 0.0001). The mean colonoscopist satisfaction in group 2 was significantly lower than that in group 1 (p = 0.047).ConclusionsIn colonoscopy, a ketofol mixture prepared in the proportion 1 : 2 provides appropriate hemodynamic conditions and sufficient sedation.

A comparison of propofol with ketofol for sedation quality and side effects in patients undergoing colonoscopy.

“…Khajavi et al (2013) compared the ketofol and propofol+fentanil combination to provide conscious sedation and analgesia in colonoscopy and found that the patient satisfaction was higher in the ketofol group while they did not find any significant differences between the hemodynamic parameters, sideeffects, and recovery times. Aydogmus et al (2015) showed that the addition of ketamine in different dosages to propofol in patients undergoing colonoscopy did not increase patient satisfaction. In this study, although there was a significant difference in the satisfaction of the person performing the colonoscopy in ketofol group, the necessity of ketamine addition into propofol is debatable.…”

A randomized controlled trial for measuring effects on cognitive functions of adding ketamine to propofol during sedation for colonoscopy

“…Ketamine/propofol admixture at even lower dosage of ketamine might lose the benefits on blood circulation and sedation effects. Aydogmus et al [ 19 ] has compared ketamine/propofol admixtures with the ratio of ketamine and propofol at 1:2 and 1:4, and found no significant difference between their post-procedure recovery time. However, patients who received ketamine/propofol admixture with 1:2 ketamine:propofol ratio showed more stable blood circulation, better sedation, and higher patient satisfaction.…”

Optimizing Outcomes for Mechanically Ventilated Patients in an Era of Endovascular Acute Ischemic Stroke Therapy

“…Emergence delirium, a well-recognized adverse effect of ketamine, is attenuated significantly when used in combination with propofol. [42][43][44][45][46] Etomidate (0.3 mg/kg dose) has similar neutral hemodynamic effects but is associated with an increased incidence of adrenal insufficiency and mortality. 47 Ketofol and etomidate are being compared in an on-going clinical trial among critically ill patients.…”