Hemodynamic stability of ketamine/propofol admixture ketofol in patients undergoing endoscopic retrograde cholangiopancreatography

Background and aim
Endoscopic retrograde cholangiopancreatography (ERCP) is a common procedure for diagnosis of many gastrointestinal tract disorders. Propofol is a commonly used agent, but we decrease its adverse effects by adding ketamine. We aimed in this study to compare propofol versus propofol–ketamine regarding hemodynamic stability, recovery, and complications in ERCP.
Patients and methods
A total of 90 American Society of Anesthesiology status II–III patients aged 18–60 years who underwent ERCP were randomly allocated by sealed envelope assignment into two groups of 45 patients each: group P received intravenous 2 mg/kg propofol and group KF received intravenous propofol–ketamine 3:1 mixture (%1 15 ml propofol + 1 ml 50 mg/ml ketamine + 4 ml saline in a 20 ml syringe, which resulted in 0.25 mg/ml ketamine and 0.75 mg/ml propofol) until Ramsay sedation scale increased to 3–4. For each patient, the following data were collected: heart rate, mean arterial blood pressure, oxygen saturation, procedure time, total drug dosage, recovery score, and patients' and the doctor's satisfaction score (clinical trial NCT02618668).
Results
The total dosage of propofol consumed was significantly higher in group P compared with group KF (283.78 ± 144.23 and 110.94 ± 51.75 mg, respectively). Recovery time was slightly longer in group P compared with group KF (20.67 ± 5.29 and 19.44 ± 4.16 min, respectively). There was a significance difference in patient satisfaction scores between group KF (1.16 ± 0.64) and group P (1.82 ± 0.83). There was a significance difference in surgeon satisfaction scores between group KF (1.11 ± 0.49) and group P (2.13 ± 0.97).
Conclusion
Propofol ketamine combination (ketofol) is associated with greater satisfaction scores and a shorter recovery than propofol and without important adverse effects in ERCP interventions.