&lt;p&gt;Comparison of ketamine-propofol mixture (ketofol) and midazolam-meperidine in endoscopic retrograde cholangiopancretography (ERCP) for oldest old patients&lt;/p&gt;

Ebru, Tarıkçı Kılıç; Resul, Kahraman

doi:10.2147/tcrm.s201441

Cited by 10 publications

(15 citation statements)

References 29 publications

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“…Better patient compliance and comfort during the surgery are guaranteed by closely monitored anaesthesia care. 1,2 ERCP involves sedation, by lowering pain, discomfort, and stress, this helps patients tolerate unpleasant and time-consuming procedures (like ERCP). 3,4 Additionally, they can make the task of the endoscopist simpler and reduce the risk of harm during ERCP.…”

Section: Introductionmentioning

confidence: 99%

“…1,4,5 The gold standard diagnostic and therapeutic approach for pancreaticobiliary diseases is the ERCP, which is frequently carried out in daycare. 2 Through ERCP, procedures like stenting, stone removal, pancreatic-biliary tract visualization, laser lithotripsy, and sphincterotomy can all be carried out. 3,6 It is necessary to have a sufficient depth of sedation or general anaesthesia for immobility, analgesia, and patient comfort.…”

Section: Introductionmentioning

confidence: 99%

“…3,6 It is necessary to have a sufficient depth of sedation or general anaesthesia for immobility, analgesia, and patient comfort. 2,7 Due to the confined access to the airway prone and semi-prone position, airway management can turn out to be difficult. 6 The ideal sedative-analgesic mixture ought to preserve a patient's hemodynamic status and ought to cause no breathing depression, a quick onset and reversal to initial values, and a small occurrence of postoperative nausea and vomiting.…”

Section: Introductionmentioning

confidence: 99%

“…6 The ideal sedative-analgesic mixture ought to preserve a patient's hemodynamic status and ought to cause no breathing depression, a quick onset and reversal to initial values, and a small occurrence of postoperative nausea and vomiting. 1,2,6 Several pharmacological medicines, including dexmedetomidine, fentanyl, ketamine, and propofol, are now widely accessible, taking into consideration short induction, rapid recovery, and lessening complications associated with using a single drug. 6 Additional small doses of supplementary medicines example ketamine and fentanyl are recommended as propofol, if administered in excess to deepen anaesthesia can have significant cardiac adverse effects.…”

Section: Introductionmentioning

confidence: 99%

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Fentanyl-Propofol Versus Ketamine-Propofol Combination for Sedation and Recovery in ERCP: A Double-Blinded Randomized Clinical Trial

Javaid¹,

Riasat²,

Shah³

et al. 2023

PJMHS

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Objective: The main goal of this study was to investigate the groups receiving fentanyl-propofol (fentP) against ketamine-propofol (ketP) in ERCP in terms of sedation, rescue sedation requirement, and recovery scores. Additionally, evaluated were the procedure's hemodynamic changes, postoperative pain score, complications, and endoscopist satisfaction. Methodology: A double-blinded randomized clinical trial was undertaken at the Dr. Ruth K.M. Pfau Civil Hospital Karachi's endoscopic room (DUHS) for six months. By using OPEN EPI sample size calculator, sample size was calculated. A total of 124 patients for elective ERCP were randomized into two groups by SNOSE protocol. Groups A and B, fentanyl-propofol (fentP) and ketamine-propofol (ketP), respectively, each contain 62 patients. All patients were given a loading dose of propofol 0.5 mg/kg, followed by a 75 ug/kg/minute infusion. The group fentP received fentanyl 1ml/kg (1 ug/kg) and the group ketP received ketamine 1ml/kg (0.5mg/kg). Ramsay sedation scores, the necessity for rescue sedation, and the Aldrete score post-operatively were noted. Hemodynamics during surgery and complications were also noted. Results: Sedation began noticeably earlier than usual in the group B at 0, 2 and 4 minutes (p-value <0.05), whereas sedation scores were higher in the group A at 8,10, and 15 minutes (p-value <0.05). Early sedation in the group B led to less consumption of rescue sedation doses (p-value <0.01). However, recovery scores were comparable in each groups (p-value >0.05). Conclusion: We were able to conclude that during ERCP, ketP had a significantly faster sedative onset than fentP, with less complication and a quicker recovery. Keywords: Propofol, KetP, FentP, ketamine, fentanyl, Sedation, Analgesia, ERCP, Monitored Anesthesia care.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Fentanyl-Propofol Versus Ketamine-Propofol Combination for Sedation and Recovery in ERCP: A Double-Blinded Randomized Clinical Trial

Javaid¹,

Riasat²,

Shah³

et al. 2023

PJMHS

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“…Therefore, accurate and repetitive assessment of sedation level is critical for safety and completion of the procedure. [ 1 , 2 ]…”

mentioning

confidence: 99%

Can Bispectral Index Monitoring (EEG) be an early predictor of respiratory depression under deep sedation during endoscopic retrograde cholangiopancreatography?

Kılıç

Sayar

2020

Sisli Etfal

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Objectives: The more often the endoscopy sedation is performed, the more the risk of adverse events, and therefore, advanced monitoring becomes more and more essential in endoscopy units. The present study aims to evaluate whether the Bispectral Index (BIS) monitoring is an early predictor of respiratory depression and to determine the compliance between commonly used clinical sedation score. Methods: This study was approved by the ethics committee. The sample consisted of 60 patients aged 18 to 50 years with an American Society of Anesthesiologists (ASA) physical status of I scheduled for endoscopic retrograde cholangiopancreatography (ERCP). All patients received propofol mediated sedation. Ramsay sedation score (RSS) was used as a clinical sedation score to assess the depth of sedation. Participants were attached to a BIS monitor. Perioperative hemodynamics, BIS values, the mean dose of propofol, procedure duration, apnea, frequency of oxygen desaturation and airway-related interventions, as well as demographic parameters, were recorded. BIS scores were blinded to RSS data. Results: The study sample consisted of 60 patients (36 females) aged 18 to 50 years (mean: 36.10±8.02). The mean procedure time and the dose of propofol were 32.70±1.79 min and 287.17±59.66 mg, respectively. The cut-off values for respiratory depression were as follows. At the 15th min of measurement, the BIS score of 60 had 96.2% sensitivity and 42.9% specificity. At the 20th min of measurement, the BIS score of 59.50 had 98.2% sensitivity and 100.0% specificity. At the 25th min of measurement, the BIS score of 59.00 had 98.3% sensitivity and 50.0% specificity. Regression analysis showed that the mean BIS score (p=0.000, 95%CI-0.110-0.043) increased by 0.076 with a unit increase in the RSS. Conclusion: BIS was highly correlated with RSS, and therefore, can be used to avoid respiratory depression during sedation.

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Ketofol performance to reduce postoperative emergence agitation in children undergoing adenotonsillectomy

Ali

Alahdal

Xia

et al. 2019

Libyan Journal of Medicine

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Background: Emergence agitation is a reformed state of mindfulness, which starts with a sudden form of anesthesia and progresses through the early repossession age. Thus, the purpose of this study is to evaluate 1:3 ketofol performance on children 3-15 years old undergoing adenotonsillectomy. Methods: A total of 60 children aged 3-15 years undergoing adenotonsillectomy were randomly allocated to receive low-dose ketamine 0.15 mg/kg followed by propofol 0.45 mg/kg i.v. ketofol (1:3) about 10 min before the end of surgery in comparison to 60 children aged 3-15 years who received only normal saline and dextrose. Anesthesia was induced and maintained with sevoflurane. Postoperative pain and EA were assessed with objective pain score (OPS) and the Pediatric Anesthesia Emergence Delirium (PAED) scale, respectively. EA was defined as a PAED 10 points. Recovery profile and postoperative complications were also recorded. Results: The incidence and severity of EA were found significantly lower in the ketofol group in comparison to the control group with a percentage of (13.33% vs 48.33%) (8% vs 15%) respectively (P < 0.05). Also, the time for interaction from anesthetic tainted to extubating in the ketofol set was significantly less than in the control group (P < 0.05). Interestingly, there are no opposing events such as nausea, laryngospasm, bronchospasm, hypotension, bradycardia, bleeding, or postoperative respiratory depression (respiratory rate: <16) were noticed in the ketofol supervision (P > 0.05). Moreover, the heart rate was meaningfully higher in the control group starting at the time of tracheal extubating in comparison to the children undergone ketofol (P < 0.05). Alert score and time from painkilling tainted till liberation from PACU showed substantial significant changes at ketofol set (P < 0.05). Conclusion: Ketofol (1:3) shows significant performance to reduce postoperative agitation in the children undergone adenotonsillectomy.

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<p>Comparison of ketamine-propofol mixture (ketofol) and midazolam-meperidine in endoscopic retrograde cholangiopancretography (ERCP) for oldest old patients</p>

Cited by 10 publications

References 29 publications

Fentanyl-Propofol Versus Ketamine-Propofol Combination for Sedation and Recovery in ERCP: A Double-Blinded Randomized Clinical Trial

Fentanyl-Propofol Versus Ketamine-Propofol Combination for Sedation and Recovery in ERCP: A Double-Blinded Randomized Clinical Trial

Can Bispectral Index Monitoring (EEG) be an early predictor of respiratory depression under deep sedation during endoscopic retrograde cholangiopancreatography?

Ketofol performance to reduce postoperative emergence agitation in children undergoing adenotonsillectomy

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