Endoskopi̇k retrograd kolanji̇yopankreatografi̇de sedasyon: Propofol ve ketami̇n karişim i̇nfüzyonunun aralikli bolus uygulamalari i̇le karşilaştirilmasi

Objective: Sedative agents such as benzodiazepines, propofol and ketamine may be administered as infusion or bolus doses for an adequate sedation during endoscopic retrograde cholangiopancreatography (ERCP). In this study, we aimed to compare drug consumption and adverse events in ERCP patients who received infusion of propofol-ketamine mixture or propofol and ketamine as bolus doses separately. Method: All data between January 2007 and January 2008 were collected from anaesthesia record in patients' files, retrospectively. Patients' demographic data, total sedative consumption, method and duration of procedure were recorded. Group I consisted of patients who received infusion of propofol-ketamine mixture and Group II consisted of patients who received propofol and ketamine as bolus doses separately. Heart rate, mean arterial pressure and O₂ saturation measured every 5 minutes and amount of drugs used were noted. Rescue sedative requirements and adverse events were assessed. Results: Records of 102 patients suitable for assessment were enrolled to the study, out of 283 patients who underwent ERCP throughout study period. There were 42 patients in Group I and 60 patients in Group II. Demographic data and operation duration were similar between two groups. There was no difference in ketamine consumption between groups, however, propofol and midazolam consumptions were significantly less in infusion group (p<0.05). There were 6 patients who experienced tachychardia in Group II, whereas tachycardia wasn't observed in Group I (p<0.05). Conclusion: The infusion of propofol-ketamine mixture during ERCP provides less consumption of sedatives and more stable sedation state than intermittent bolus administration of the same drugs separately.