Propofol dexmedetomidine versus propofol ketamine for anesthesia of endoscopic retrograde cholangiopancreatography (ERCP) (A randomized comparative study)

Sedative and Analgesic Effects of Propofol-Fentanyl Versus Propofol-Ketamine During Endoscopic Retrograde Cholangiopancreatography: A Double-Blind Randomized Clinical Trial

“…ERCP complications can be related to sedation, such as arrhythmia, hypoxia, hypotension, and hypoventilation. The main challenges for the anesthesiologist during ERCP are apnea and airway obstruction, particularly with the patient in the prone position (due to the unavailability of the airways) (2, 3, 5, 6). …”

“…Administering high doses of propofol to deepen the anesthesia leads to dangerous cardiopulmonary side effects. Therefore, adding low doses of other drugs, such as ketamine and fentanyl, is recommended (1, 3, 9). …”

“…Low doses (less than 0.5 mg/kg) have acceptable analgesic and hypnotic effects, but also cause lower respiratory depression and fewer cardiac complications (3, 6, 7, 10-14). …”

“…These drugs are associated with complications, such as hypotension, respiratory depression, arterial oxygen desaturation, bradycardia, nausea, and vomiting (1, 14-16). To prevent or reduce these complications, other analgesic medications can be used in place of fentanyl (2, 3, 16). Studies have shown that the combination of ketamine and propofol can effectively prevent deep sedation of patients and cause lower postoperative nausea and vomiting, more stable hemodynamics, and a shorter discharge time after ERCP (11, 12, 16-18).…”

Ketamine and Dexmedetomidine for Day Care Anaesthesia in Paediatric Surgery

“…It attenuates stress-induced sympathoadrenal responses protecting the patients from noxious sympathetic stimulation and haemodynamic changes. 3 A prospective observational study to evaluate the efficacy of Ketamine with Dexmedetomidine combination as an anaesthetic in paediatric day care surgeries was done.…”