to compare the efficacy of propofol with ketamine versus propofol with fentanyl for procedural sedation for patients undergoing endoscopic retrograde cholangiopancreatography

Abstract

Objective: This study was conducted to compare the efficacy of Propofol with Ketamine versus Propofol with Fentanyl for procedural sedation for patients undergoing ERCP to evaluate Propofol consumption, recovery score, patient satisfaction and sedation related adverse events. Materials and Methods: Sixty patients aged 18-60 years, ASA Class I and II were randomly allocated to one of two groups; Propofol/Ketamine (Ketofol) group KP (n=30) and Propofol/Fentanyl group FP (n=30). The level of sedation was adjusted to achieve a Ramsay Sedation Scale (RSS) score of 5. Results: The total amount of Propofol consumed was significantly higher in FP group (109.883±11.3871 mg) compared to KP group (89.867±9.8942 mg). Time to reach acceptable recovery score was slightly longer in KP group compared to FP (Aldrete scores 9.5±0.509, 9.8±0.407 respectively at 30 min). Patient satisfaction was comparable in both the groups and sedation related side effects like hypotension, bradycardia, desaturation was more significant in FP group compared to KP group. Conclusion: Propofol-Ketamine combination provided sedation quality similar to Propofol-Fentanyl combination with better hemodynamic profile and fewer side effects. Hence Propofol-Ketamine combination can be safely used in patients undergoing ERCP.