Comparison of Fentanyl Citrate-midazolam-propofol and Fentanyl Citrate-ketamine Propofol Combinations with Regards to Efficiency and Safety in Sedation Practices for the ERCP
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2014, Vol 4, Issue 19
Abstract
Aims: The objective of our study is to compare the efficiency and safety of fentanyl citrate-midazolam-propofol combination with fentanyl citrate-ketamine-propofol combination used as sedative and analgesic medication in patients undergoing ERCP procedure. Study Design: Randomized and prospective. Place and Duration of Study: Department of Anaesthesiology and Reanimation (Gastroenterology Unit) between June 2009 and June 2010. Methodology: 103 patients undergoing ERCP aged between 20-80 years, ASA I-III, participated in our study. Cases were randomly divided into two groups as group M(n=51) and group K(n=52). Fentanyl citrate 1 µg/kg IV was infused to all patients 5 minutes before the process. Group M: In addition to fentanyl, midazolam 0.04 mg/kg IV and propofol loading dose of 1mg/kg IV and maintenance dose of 4mg/kg/h IV were also infused. Group K: In addition to fentanyl, ketamine 0.5mg/kg IV and propofol loading dose of 1mg/kg IV and maintenance dose of 4mg/kg/h IV were infused as well. At the end of ERCP procedure, propofol infusion was terminated. The time required for the Richmond Alertness-Sedation Scale (RASS) score to reach -1 (recovery period) and its change from -1 to 0 in recovery room (discharge period) and also the development of side effects during the practice were recorded. After recovery period the patients were questioned if they felt pain during the procedure or not. If they felt any, the pain was evaluated according to Visual Analog Scale (VAS) score. Results: Recovery period, discharge period and satisfaction of the endoscopist were similar between the two groups, however cardiovascular and respiratory system parameters were more stable in patients in Group K. Conclusion: Our study pointed that fentanyl citrate-ketamine-propofol combination is probably preferable over fentanyl citrate-midazolam-propofol combination in terms of cardiovascular and respiratory stability during sedation in ERCP procedures.
Authors and Affiliations
H. Kara, M. Aksun, G. Aran, U. Ozgurbuz, A. Sencan, L. Koroglu, N. Karahan
Keywords
Related Articles
- EP ID EP349343
- DOI 10.9734/BJMMR/2014/8541
- Views 67
- Downloads 0
Calcium Polycarbophil in the Management of Fecal Incontinence
Background: Few clinical studies have assessed the efficacy of calcium polycarbophil that is currently recommended as an ideal and initial bulk-forming agent in patients with fecal incontinence. Aims: The aim of this st...
Neurologic Outcome after Asphyxial Cardiac Arrest in a Juvenile Porcine Model: Comparison of Epinephrine and Vasopressin, Alone or Combined with Nitroglycerin
Aims: Hypoxemic encephalopathy is a devastating complication of asphyxial cardiac arrest in children, commonly occurring despite prompt resuscitation. Epinephrine, incorporated in present algorithms, may contribute to un...
Challenges in Providing Rehabilitation Services for People with Disabilities in Iran: A Qualitative Study
Introduction: World Health Organization (WHO) recognizes disability as a global public health issue and a development priority, but unfortunately, the evidence shows that people with disabilities (PWD) often have lower l...
Bronchial Sleeve Resection for Lung Cancer Preoperative Empyema
Surgical management of the cancer with empyema has rarely been reported in the literature because few of such cases are operable. Many patients might be misevaluated because of the incorrect staging associated with an ac...
Investigating of Mothers' Behavior Based on the Health Belief Model about Using Iron Supplementation in 6 to 24- Month Old Children in Shahrekord City, Iran
Background: Anemiais one of the most important problems in children's public health. Iron Deficiency Anemia is the most common type of anemia among this group. This study was conducted to determine mothers' behavior base...