Comparison of Ketamine-Midazolam-Propofol Combination and Fentanyl-Midazolam-Propofol Combination for Sedation in Colonoscopy

INTRODUCTION: In this study, we aimed to compare the combination of ketamine-midazolam-propofol (KMP group) with fentanyl-midazolam-propofol (FMP group) for sedoanalgesia in ASA I-II adult patients undergoing colonoscopy in terms of patient satisfaction, side effects, and technical characteristics such as procedure duration and recovery time.
METHODS: A total of 60 ASA I-II patients who underwent colonoscopy were randomly divided into two groups. Both groups received 1 mg midazolam and 30-50 mg propofol. 50 mg ketamine was administered to the KMP group and 50 mg fentanyl to the FMP group. The additional dose of propofol was determined by the anesthesiologist to achieve 4-5 sedation level of Ramsay Sedation Scale. At the end of the procedure, propofol consumption dose, side effects, the duration of the procedure, and the recovery time of the patients were recorded. Mann-Whitney U test, Chi-square, and Fischer’s exact test were used to analyze data.
RESULTS: Total propofol consumption of FMP group was significantly higher (p ˂ 0.05) than KMP group. The procedure time in the FMP group was significantly lower (p ˂ 0.05) than the KMP group.
DISCUSSION AND CONCLUSION: The combination of ketamine-midazolam-propofol and fentanyl-midazolam-propofol can be used safely in terms of patient satisfaction and cardiovascular and other possible side effects. The combination of ketamine-midazolam-propofol is superior to the combination of fentanyl-midazolam-propofol thanks to the use of propofol in lower quantities.