Propofol-ketamine combination: a choice with less complications and better hemodynamic stability compared to propofol? On a prospective study in a group of colonoscopy patients

Tutal, Zehra Baykal; Güleç, Handan; Dereli, Necla; Babayiğit, Münire; Kurtay, Aysun; İnceöz, Hansa; Horasanlı, Eyüp

doi:10.1007/s11845-015-1348-8

Cited by 16 publications

(10 citation statements)

References 18 publications

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“… 19 It has been suggested that when propofol is added to ketamine, it reduces these effects by sympathetic neutralization and hemodynamic stabilization. 19 - 22 In this study, we observed similar hemodynamic stabilization. Owing to the cardio-depressive effects of both propofol and alfentanil, the combination of these drugs results in hemodynamic instability.…”

Section: Discussionsupporting

confidence: 81%

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

Kilic

Demiriz

Işıkay

et al. 2016

SMJ

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Objectives:To observe the effects of both propofol/alfentanil and propofol/ketamine on sedation during upper gastrointestinal system endoscopy in morbidly obese patients (UGSEMOP).Methods:In a prospective, double-blinded, randomized clinical study, 52 patients scheduled for UGSEMOP were assigned to either group A (n=26; 10 µg/kg intravenous [IV] alfentanil) or group K (n=26; 0.5 mg/kg IV ketamine). Each patient was administered 0.7 mg/kg propofol for induction. If it was needed, the patients were administered an additional dose of IV propofol. This study was performed in Sehitkamil State Hospital, Gaziantep, Turkey, between January 2014-2015. Total propofol consumption, time to achieve Modified Aldrete Scores (MAS) of 5 and 10 following the procedure, physician and patient satisfaction scores, and instances of side effects, such as bradycardia and hypotension were recorded.Results:Time to onset of sedation and duration of sedation were both significantly shorter in group A. Patients in group A also required less time to achieve an MAS of 5. Total propofol consumption was significantly lower in group A.Conclusion:Both propofol/alfentanil and propofol/ketamine combinations provided appropriate hypnosis and analgesia during UGSEMOP. However, propofol consumption was significantly higher using the propofol/ketamine combination.

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Section: Discussionsupporting

confidence: 81%

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

Kilic

Demiriz

Işıkay

et al. 2016

SMJ

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“…[25] The use 0.5 mg/kg of ketamine with or without propofol may eliminate emergence reactions. [28][29] We did not observe emergence reactions in any patient after the procedure because of low-dose ketamine combined with propofol.…”

Section: Discussionmentioning

confidence: 69%

“…[32] Previous studies have revealed that the use of larger initial bolus doses of propofol was associated with higher incidence of hypotension. [22][23][24][25][26][27][28][29][30] Hsieh et al [21] reported hypotension incidence as 23% for an initial bolus of 1 mg/kg propofol, which was then titrated in 10-20 mg increments plus 25 mg of meperidine (dose of propofol, 129.80±37.93 mg). In contrast, Sáenz-López et al [30] reported no hypotension for an initial bolus of 20 mg of propofol, followed by boluses of 10 mg every 30 s plus 25-50 mg of meperidine (dose of propofol, 66.93 mg).…”

Section: Discussionmentioning

confidence: 99%

Alternative sedation regimens for upper gastrointestinal endoscopy proven to be safe. A retrospective comparative study

Uzman

Gürbulak²,

Baltalı

et al. 2017

EJMO

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“…The sedative patients were discharged from the RR when they met discharge criteria (23). The probability of early discharge from PACU is an essential feature in the care of outpatients and produces better service and lower costs (24).…”

Section: Discussionmentioning

confidence: 99%

Sedation for Colonoscopy: Comparison of Remifentanil and Alfentanil Combined with Propofol/Midazolam

Arıcan¹,

Çiçekci²,

Hacıbeyoğlu³

et al. 2019

Istanbul Med J

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Amaç: Kolonoskopi işlemi uygulanan hastalara güvenli sedasyon ve erken taburculuk amacıyla farklı ilaç kombinasyonları kullanılmaktadır. Remifentanil ve alfentanil kısa etkili narkotik analjezik ajanlardır. Kısa etkili bir anksiyolitik ajan olan midazolam narkotik analjeziklerle kombine edildiğinde güçlü bir sedadif etkinliğe sahiptir. Kolonoskopi işlemi altındaki hasta da sedasyon amacıyla literatürde karşılaştırılmamış 2 opiodin propofol/midazolam ile kombinasyonunun etkinliğini karşılaştırmayı amaçladık. Yöntemler: Çalışmaya tanı ve/veya tedavi amaçlı kolonoskopi uygulanan 18 yaş üzeri yüz seksen dokuz hasta alındı. Alfentanil grubunda (grup A) 1 mg midazolam + 5 µg kg-1 alfentanil + 1 mg kg-1 propofol ve remifentanil grubuna (grup R) 1 mg midazolam + 0.1 µg kg-1 dk-1 remifentanil + 1 mg kg-1 propofol uygulandı. Hemodinamik veriler, Modifiye Steward skalası (MSS), Görsel Analog skala (VAS), ek propofol dozları, toplam işlem süresi, uyanma süresi, iyileşme süresi ve yan etkiler işlem sırasında kaydedildi. İşlem sonrası tüm hastalar derlenme odasına transfer edildi ve Modifiye Aldrete skalası (MAS) değerleri kaydedildi. Bulgular: Total propofol ve ek propofol dozlarında gruplar arasında istatistiksel olarak anlamlı farklılık saptanmıştır (p<0.05), ve grup A da grup R ye göre propofol ek dozunun daha yüksek olduğu gözlenmiştir (p<0.05). Uyanma süresi gruplar arasında benzerdi. Derlenme süresinin grup A'da grup R'ye göre daha uzun olduğu tespit edildi (p<0.05). Gruplar arasında yan etkilerde anlamlı farklılık saptanmamıştır. Sonuç: Propofol/remifentanil ve propofol/alfentanil ile kombine edilen düşük doz midazolam etkili sedasyon ve analjezi sağlamasına rağmen, remifentanilin, farmakolojik özelliklerinden doğan avantajları nedeniyle kolonoskopi gibi günlük işlemler için ideal bir seçim olduğuna inanıyoruz.

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Propofol-ketamine combination: a choice with less complications and better hemodynamic stability compared to propofol? On a prospective study in a group of colonoscopy patients

Abstract: Propofol-ketamine combination is an advantageous choice in means of achieving sedation in a shorter period of time, a better hemodynamic stability, less nausea and vomiting and respiratory complication rates. Yet it seems that this choice might be related with longer recovery duration.

Cited by 16 publications

References 18 publications

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

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

Alternative sedation regimens for upper gastrointestinal endoscopy proven to be safe. A retrospective comparative study

Sedation for Colonoscopy: Comparison of Remifentanil and Alfentanil Combined with Propofol/Midazolam

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