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Colorectal
PWE-105 Clinical efficacy of the combination of propofol and ketamine (ketofol) for deep sedation for colonoscopy
  1. S Amornyotin,
  2. W Chalayonnawin,
  3. S Kongphlay
  1. Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Abstract

Introduction A combination of propofol and ketamine is usually used to achieve sedation and analgesia during colonoscopy. Few studies have compared their efficacy. The aim of this study was to compare and evaluate the clinical efficacy of the combination of propofol and ketamine (ketofol) vs propofol alone when each regimen is used as sedative agents for colonoscopy.

Methods 194 patients who underwent colonoscopy in 2 years, were randomly assigned to PN and PK groups. 97 patients in group PN received propofol and normal saline and 97 patients in group PK received propofol and ketamine for intravenous sedation (IVS). All patients were premedicated with 0.02–0.03 mg/kg of midazolam. The primary outcome variable was the successfully completed colonoscopic procedure. The secondary outcome variables were patient tolerance, discomfort during insertion, patient and endoscopist satisfaction, haemodynamic responses, as well as complications during and immediately after procedure. Immediately after the procedure, the endoscopist was asked to rate tolerability for the patient, discomfort during insertion and satisfaction. As well, a blinded member of the research team evaluated the patient satisfaction, procedural pain, recovery time and recovery score.

Results All endoscopies were completely successfully. Mean total dose of propofol in group PK and PN was 6.98 (2.90) mg/hg/h and 7.73 (3.45) mg/kg/h, respectively (p=0.413). Mean total dose of ketamine in group PK was 1.49 (0.61) mg/hg/h. There were no significant differences in patient tolerance, discomfort during insertion, patient and endoscopist satisfaction, haemodynamic responses, procedural pain, recovery time and recovery score. Overall, cardiovascular and respiratory adverse events were not significantly different between the two groups. These adverse events were transient and easily treated with no sequelae.

Conclusion IVS in both regimens provided effective and safe for colonoscopy. Adverse events were relatively high in both groups. However, these adverse events were mild and transient. No serious adverse events were observed.

Competing interests None declared.

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