Ketamine versus alfentanil combined with propofol for sedation in colonoscopy procedures: A randomized prospective study

Abstract

Background/Aims: Different drug combinations are used for sedation in colonoscopy procedures. A ketaminepropofol (ketofol) mixture provides effective sedation and has minimal adverse effects. Alfentanil also provides anesthesia for short surgical procedures by incremental injection as an adjunct. However, no study has investigated the use of ketofol compared with an opioid-propofol combination in colonoscopic procedures. Materials and Methods: A total of 70 patients, ASA physical status I-II, scheduled to undergo elective colonoscopy, were enrolled in this prospective randomized study and allocated to two groups. After premedication, sedation induction was performed with 0.5 mg/kg ketamine +1 mg/kg propofol in Group KP, and 10 mg/kg alfentanil +1 mg/kg propofol in Group AP. Propofol was added when required. Demographic data, colonoscopy duration, recovery time, discharge time, mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation, Ramsey Sedation Scale values, colonoscopy patients' satisfaction scores, and complications were recorded. Results: The need for additional propofol doses was significantly higher in Group AP than in Group KP. MAP at minute 1 and 5, Ramsey Sedation Scale at minute 5, and discharge time were significantly higher in Group KP than in Group AP. Additional propofol doses and total propofol dose were significantly lower in Group KP than in Group AP. Conclusion: Ketofol provided better hemodynamic stability and quality of sedation compared with alfentanilpropofol combination in elective colonoscopy, and required fewer additional propofol; however, it prolonged discharge time. Both combinations can safely be used in colonoscopy sedation.

Clinical Efficacy of Combination of Propofol and Ketamine(Ketofol) for Deep Sedation in Colonoscopic Procedure

“…However, the discharge time in both groups was comparable. This was different from the study of Turk and colleagues [17] . Their study compared the ketofol with the combination of alfentanil and propofol in elective colonoscopic patients.…”

Use of diphenhydramine as an adjunctive sedative for colonoscopy in patients on chronic opioid therapy: a randomized controlled trial

“…11,12 Based on anecdotal data, the use of adjunct sedatives or deep sedation is often used with these patients. [19][20][21][22][23] Because of its hypnotic and sedative properties, diphenhydramine is recommended for endoscopic procedures in difficult-to-sedate patients, but the studies supporting its use have yielded conflicting results. 13,18 We designed a randomized controlled study to systemically analyze the use of diphenhydramine as an adjunct to routinely used sedatives in patients on chronic opioids.…”

Alfentanil versus ketamine combined with propofol for sedation during upper gastrointestinal system endoscopy in morbidly obese patients

“…In studies performed by Türk et al 8 , propofol was combined with ketamine and alfentanil for sedation in colonoscopy procedures. Between the 2 protocols, it was observed that the combination of propofol and ketamine resulted in a longer time to onset of sedation and a longer duration of action.…”

“… 6 Ketamine has amnesic and analgesic properties and therefore is well-suited for short procedures. 7 , 8 This prospective, randomized, double-blind study planned to compare propofol/alfentanil and propofol/ketamine combinations for use during UGSEMOP.…”