A comparison between propofol with ketamine (ketafol) and propofol with ephedrine for sedation on hemodynamic parameters in patients undergoing colonoscopy: a randomized controlled trial

Abstract

     This study aimed to investigate sedation efficacy during colonoscopy by comparing the combination of propofol with ketamine (PK) to propofol with ephedrine (PE). A randomized double-blind controlled trial with a parallel design was conducted in 70 patients. Participants were randomly assigned to the PK group (n = 35) or the PE group (n = 35). Blood pressure (BP) and heart rate (HR) were compared during sedation for colonoscopy at Kuchinarai Crown Prince Hospital, Kalasin Province. Baseline data were recorded before, during, and after sedation. The sedation level was assessed. Vital signs, total medication dosage, recovery time, pain scores, and complications were documented. Data collection used a researcher-developed tool.

     The results showed that seventy patients were included (PK group, n = 35; PE group, n = 35) with no dropouts. After colonoscopy, the mean systolic blood pressure (SBP) differed significantly between groups (P < 0.001), with a mean difference of 18.26 mmHg (95% CI 11.55–24.67). The mean diastolic blood pressure (DBP) also showed significant differences both during (mean difference, 6.42 mmHg; 95% CI, 11.55–24.67) and after colonoscopy (mean difference, 13.17 mmHg; 95% CI, 7.64–18.70; both P < 0.001). Heart rate showed no significant differences at any time points. Sedative dosage and pain scores during colonoscopy differed significantly (P < 0.001), but recovery time showed no difference (P = 0.667). Complications (hypotension, hypertension, bradycardia) did not differ significantly between groups.