+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Assessment of the effects of ketamine-fentanyl combination versus propofol-remifentanil combination for sedation during endoscopic retrograde cholangiopancreatography

, : Assessment of the effects of ketamine-fentanyl combination versus propofol-remifentanil combination for sedation during endoscopic retrograde cholangiopancreatography. Journal of Research in Medical Sciences 19(9): 860-866

Endoscopic retrograde cholangiopancreatography (ERCP) as a diagnostic and treatment procedure is used in most biliary tract and pancreatic. Either sedation or general anesthesia could be considered for this procedure. Combining a sedative with an opioid agent can provide effective moderate sedation. This study compared the impact of ketamine-fentanyl (KF) versus propofol-remifentanil (PR) on sedation scale in patients undergoing ERCP. As a double-blinded randomized clinical trial, 80 patients selected by convenient sampling, allocated randomly into two groups. KF group received ketamine 0.5 mg/kg body weight intravenously over 60 s and then fentanyl 1 mcg/kg body weight intravenously. PR group received propofol l mg/kg body weight intravenously over 60 s and then remifentanil 0.05 mcg/kg body weight/min intravenously. Intravenous (IV) infusion of propofol was maintained by 50 mcg/kg body weight/min throughout ERCP. Ramsay Sedation Score, vital signs, oxygen saturation (SpO2), recovery score (modified Aldrete score) and visual analog scales of pain intensity, and endoscopist's satisfaction were considered as measured outcomes. All analysis were analyzed by SPSS Statistics version 22 and using t-test, Chi-square and repeated measured ANOVA and Mann-Whitney tests for data analysis. Respiratory rate and SpO2 level during the time intervals were lower in PR group (P < 0.001). Sedation score at intervals was not significantly different (P = 0.07). The frequency of apnea in PR group was significantly higher than the KF group (P = 0.003). The percentage of need to supplemental oxygen in PR group was 35.1% that was also significantly higher than 8.8% in the KF group (P = 0.008), but the dosage frequency was significantly higher in KF group (P < 0.001). The KF and PR groups average length of stay in the recovery room were 50.71 standard deviation (SD = 9.99) and 42.57 (SD = 11.99) minutes, respectively, indicating a significant difference (P = 0.003). The mean severity of nausea in KF and PR groups was, respectively, 2.74 confidence interval (CI = 1.68-3.81) and 0.43 (CI = 0.11-0.75), that was significantly higher in KF group (P < 0.001). The average score of surgeon satisfaction in both KF and PR groups were 7.69 (CI = 7.16-8.21) and 8.65 (CI = 8.25-9.05), respectively, which was higher in KF group (P = 0.004), but the average level of patients satisfaction in KF group was 8.86 (CI = 8.53-9.19) and in PR group was 8.95 (CI - 8.54-9.35) that were not significantly different (P = 0.074). There is no statistically significant difference between KF and PR combinations in sedation score, but PR combination provides better pain control, with less nausea and shorter recovery time while causing more respiratory side effects, that is, apnea and need to oxygen.


PMID: 25535501

Other references

Itaya, S.; Ishizuka, T.; Wada, H.; Kimura, M.; Ishizawa, M.; Kanoh, Y.; Kajita, K.; Miura, A.; Yasuda, K., 1997: Effect of troglitazone on thrombin-induced platelet aggregation mechanism in vitro. Diabetologia 40(SUPPL 1): A146

Molvarec, A.; Jermendy, A.; Nagy, Bálint.; Kovács, M.; Várkonyi, T.; Hupuczi, P.; Prohászka, Zán.; Rigó, János., 2008: Association between tumor necrosis factor (TNF)-alpha G-308A gene polymorphism and preeclampsia complicated by severe fetal growth restriction. Background: Preeclampsia and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome are multifactorial disorders with genetic and environmental components. Given that the tumor necrosis factor (TNF)-alpha G-308A single nucleot...

Treshchina N.I., 1955: Izuchenie neftyanykh gazov Tersko- Dagestanskoi oblasti. Several genetic types are distinguished among the gas components of the petroleum deposits of the Terek-Dagestan region, USSR. The priincipal type belongs to the hydrocarbon group (methane). A correlation was found to exist between the chemical co...

Joshi D.W., 1997: Giral lignite deposit of Barmer District, Rajasthan. Pages 82-84 1997

Cagigal, M.P.; Prieto, P., 1992: Evaluation of triple correlation from triggered factorial moment measurement. Triple-correlation values are obtained as a combination of second-order factorial moments of the triggered photocount distribution. The signal-to-noise ratio obtained from this kind of measurement is smaller than that obtained from direct calculat...

Chong, E.; Winikoff, B.; Charles, D.; Agnew, K.; Prentice, J.L.; Limbago, B.M.; Platais, I.; Louie, K.; Jones, H.E.; Shannon, C.; Kohler, C.; Bennett, B.; Doyle, M.; Thielges, S.; Eschenbach, D.; Cookson, B.; Avillan, J.; Kitchel, B.; Hubbard, A.; MacCannell, D.; Rasheed, J.K.; Callaghan, W.M.; McDonald, L.C.; Castillo, P.; Martin, R.; Sobieski, R.; Veatch, M.; Coral, A.; Corredor, P.; Eder, S.; Sheehan, K.; Middleton, T.; Lichtenberg, E.S.; Nucatola, D.; Eggleston, K.; Bednarek, P.; Miller, R.;, 2016: Vaginal and Rectal Clostridium sordellii and Clostridium perfringens Presence Among Women in the United States. To characterize the presence of Clostridium sordellii and Clostridium perfringens in the vagina and rectum, identify correlates of presence, and describe strain diversity and presence of key toxins. We conducted an observational cohort study in wh...

Bodenheimer, M.; Casten, D.; Fried, J.J., 1947: A study of the modern methods of the treatment of intestinal obstruction. Journal of the International College of Surgeons 10(2): 174-184

Jack M.A.; Schmidt E.L.; Wold F., 1979: Studies on the in vivo function of soybean lectin. Federation Proceedings 38(3 PART 1): 411

Duncan, B., 1982: Division accomplishments: insuring the future. Virginia wildlife: 437-8

Bain, B.; Lowenstein, L.; Kasakura, S.; Vas, M., 1968: The mixedd leukocyte reaction and its potential use in tissue matching. Bibliotheca Haematologica 29: 617-627