Effect of ketamine and fentanyl in combination with midazolam and propofol during outpatient colonoscopy-a randomised controlled trial

Madhusudan Upadya, S. Neeta, Gagan Brar, Anand Kulkarni, Jose Chacko

Research output: Contribution to journalArticle

Abstract

Introduction: There are various methods for sedation in colonoscopy and ketamine has been found to be an effective alternative drug for sedation. Aim: To compare the efficacy and haemodynamic stability of lower dose of ketamine and fentanyl co-administered with midazolam and propofol for colonoscopy. Materials and Methods: Sixty American Society of Anaesthesiologists (ASA) I-II patients undergoing colonoscopy were randomised into two groups. Group I (n=30) (Fentanyl group) was assigned to receive midazolam 20µg/kg, propofol and fentanyl 2µg/kg. Group II (n=30) (Ketamine group) was assigned to receive midazolam 20µg/kg, propofol and ketamine 0.5mg/kg. The parameters measured include haemodynamic stability, recovery, pain scores and endoscopists' satisfaction. All statistical analysis was carried out using Medcalc Statistical Software version 11.0 (Medcalc Software bvba, Belgium). Results: The time to full sedation in the ketamine group was significantly less than that in the fentanyl group (18.3±2.7 seconds Vs 22.4±2.2 seconds). Patients belonging to the ketamine group had a significantly shorter recovery time compared to those in the fentanyl group (5.8±1.4 Vs 8.0±1.9 minutes). Overall patient satisfaction was significantly higher with the use of ketamine. Patients were haemodynamically more stable with a lower incidence of hypotension in ketamine group. Conclusion: The present study shows that midazolam/ketamine/propofol combination provides adequate levels of analgesia and sedation, quicker recovery and has “propofol sparing” effect.

Original languageEnglish
Pages (from-to)UC05-UC09
JournalJournal of Clinical and Diagnostic Research
Volume12
Issue number9
DOIs
Publication statusPublished - 01-09-2018

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Midazolam
Ketamine
Fentanyl
Propofol
Colonoscopy
Outpatients
Randomized Controlled Trials
Hemodynamics
Recovery
Software
Belgium
Patient Satisfaction
Hypotension
Analgesia
Statistical methods
Pain
Incidence

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry

Cite this

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abstract = "Introduction: There are various methods for sedation in colonoscopy and ketamine has been found to be an effective alternative drug for sedation. Aim: To compare the efficacy and haemodynamic stability of lower dose of ketamine and fentanyl co-administered with midazolam and propofol for colonoscopy. Materials and Methods: Sixty American Society of Anaesthesiologists (ASA) I-II patients undergoing colonoscopy were randomised into two groups. Group I (n=30) (Fentanyl group) was assigned to receive midazolam 20µg/kg, propofol and fentanyl 2µg/kg. Group II (n=30) (Ketamine group) was assigned to receive midazolam 20µg/kg, propofol and ketamine 0.5mg/kg. The parameters measured include haemodynamic stability, recovery, pain scores and endoscopists' satisfaction. All statistical analysis was carried out using Medcalc Statistical Software version 11.0 (Medcalc Software bvba, Belgium). Results: The time to full sedation in the ketamine group was significantly less than that in the fentanyl group (18.3±2.7 seconds Vs 22.4±2.2 seconds). Patients belonging to the ketamine group had a significantly shorter recovery time compared to those in the fentanyl group (5.8±1.4 Vs 8.0±1.9 minutes). Overall patient satisfaction was significantly higher with the use of ketamine. Patients were haemodynamically more stable with a lower incidence of hypotension in ketamine group. Conclusion: The present study shows that midazolam/ketamine/propofol combination provides adequate levels of analgesia and sedation, quicker recovery and has “propofol sparing” effect.",
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Effect of ketamine and fentanyl in combination with midazolam and propofol during outpatient colonoscopy-a randomised controlled trial. / Upadya, Madhusudan; Neeta, S.; Brar, Gagan; Kulkarni, Anand; Chacko, Jose.

In: Journal of Clinical and Diagnostic Research, Vol. 12, No. 9, 01.09.2018, p. UC05-UC09.

Research output: Contribution to journalArticle

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T1 - Effect of ketamine and fentanyl in combination with midazolam and propofol during outpatient colonoscopy-a randomised controlled trial

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AU - Brar, Gagan

AU - Kulkarni, Anand

AU - Chacko, Jose

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