SEDATION WITH KETOFOL (KETAMINE AND PROPOFOL ADMIXTURE) VERSUS PROPOFOL DURING MONITORED ANESTHESIA IN PATIENTS UNDERGOING ERCP

Background: Adequate and safe patient sedation is mandatory for most interventional endoscopic procedures. Combination of ketamine and propofol (ketofol) at varying doses could be used and could have more favorable hemodynamics than the gold standard prototypic agent (propofol). Methods: two hundred patients scheduled for undergoing (ERCP) were randomly allocated to receive either propofol or ketofol (propofol and ketamine) for sedation during the procedure. Respiratory and hemodynamic monitoring, doses needed for sedation, recovery profile and patient, nurse and doctor satisfaction were assessed. Results: The induction and maintenance doses of propfol were statistically significantly higher in propfol group than ketofol group. Time till sedation and duration of procedure were statistically significantly shorter in ketofol group than in propfol group. The incidence of hypotension was statistically significantly higher in propfol group than in ketofol group. Mean ETcoi during sedation was statistically higher than pre-sedation in propfol group, and was statistically significantly higher than during sedation in ketofol group. The incidence of nausea and emergence reaction was not statistically significant The median recovery time was longer in ketofol group than propfol group but not statistically significant. Patient, nurse and doctor satisfaction was statistically significantly higher in ketofol group than in propofol group. Conclusion Ketofol sedation and analgesia is effective and appears to be safe for endoscopic procedures.