A comparative study between propofol–ketamine and propofol–fentanyl for sedation during pediatric diagnostic upper gastrointestinal endoscopy

Background
The aim of this study was to compare propofol–ketamine (ketofol) with propofol–fentanyl in pediatric patients undergoing diagnostic upper gastrointestinal endoscopy.
Patients and methods
This was a prospective, randomized, double-blinded study to compare the effect of propofol–ketamine and propofol–fentanyl on oxygen saturation, heart rate (HR), and systolic blood pressure (SBP) when used for sedation in pediatric patients undergoing elective upper gastrointestinal endoscopy. Sixty ASA I–II patients, aged 6–12 years were included in the study. Oxygen saturation, HR, and SBP of all patients were recorded perioperatively, after induction, 5 min later, and at the end of the procedure. All patients received propofol 1.5 mg/kg, intravenous + either fentanyl 1 μg/kg, intravenous (propofol–fentanyl group) or ketamine 0.5 mg/kg, intravenous (propofol–ketamine group). The procedure started when the sedation score was 4–6. Additional propofol (1 mg/kg) was administered when needed in either group. Demographic data, operative data, and intraoperative and postoperative side effects (hypoxia, nausea and/or vomiting, increased oral secretions, and emergence reactions, or hallucinations) were recorded.
Results
There were no significant differences between both groups regarding the demographic and operative data (duration of the procedures, onset of anesthesia, number of patients needed additional dose (s), recovery time, discharge time, modified Ramsay sedation scale). The mean values of oxygen saturation, HR, and SBP were significantly lower ( < 0.05) in the propofol–fentanyl group than the propofol–ketamine group after induction, 5 min later, and at the end of the procedure. No significant difference regarding intraoperative and postoperative side effects between both groups ( > 0.05).
Conclusion
Propofol–ketamine 3: 1 mixture was associated with hemodynamic stability and better oxygen saturation without affecting the recovery and without significant side-effects.