Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients: A randomized double-blinded trial
ABSTRACTBackground A wide range of drugs are used for sedation in gastrointestinal (GI) endoscopy procedures, including midazolam, dexmedetomidine, and ketamine. Therefore, this study aimed to compare the effects of these drugs in combination with propofol among cancer patients undergoing GI endosco...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2023.2230404 |
| _version_ | 1797789082907049984 |
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| author | Nahla N Shehab Walaa Y Elsabeeny Sayed M Abed |
| author_facet | Nahla N Shehab Walaa Y Elsabeeny Sayed M Abed |
| author_sort | Nahla N Shehab |
| collection | DOAJ |
| description | ABSTRACTBackground A wide range of drugs are used for sedation in gastrointestinal (GI) endoscopy procedures, including midazolam, dexmedetomidine, and ketamine. Therefore, this study aimed to compare the effects of these drugs in combination with propofol among cancer patients undergoing GI endoscopy.Methods This randomized, double-blinded study was carried out on 75 cancer patients who underwent GI endoscopy. Patients were categorized into three equal groups. Group D: received dexmedetomidine 0.5 µg/kg bolus infusion over 10 min. Group K: received ketamine 0.5 mg/kg. Group M: received midazolam 0.05 mg/kg. With these drugs, 0.5 mg/kg propofol was administered intravenously with incremental 20 mg till achievement of Ramsey sedation score (RSS) 3–4. After that, 0.5 mg/kg propofol boluses were offered for rescue sedation.Results The endoscopy duration was comparable in the three groups. Time of RSS 3–4 achievement and total propofol dose (P < 0.05) were significantly lower in group D and group K compared to group M. Time to eye-opening were significantly lower in groups D, and K compared to group M, with insignificant difference between group K and group D. Moreover, the heart rate (HR) and mean arterial pressure (MAP) of group K at 10 min, 15 min, 20 min, 25 min, and 30 min, and PACU were significantly greater than D and M groups (P < 0.05). Incidence of hypotension and bradycardia were comparable in the three groups.Conclusions In cancer patients who underwent GI endoscopy, dexmedetomidine-propofol and ketamine-propofol had better sedation efficacy [lower achievement time of RSS 3–4, total propofol dose, and eye-opening time] compared to midazolam-propofol group with superior sedative effect of ketamine-propofol than dexmedetomidine-propofol. While ketamine-propofol had more stable HR and MAP. |
| first_indexed | 2024-03-13T01:45:44Z |
| format | Article |
| id | doaj.art-7a7ebae3c07d4395b2a6dcf476b90522 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-03-13T01:45:44Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-7a7ebae3c07d4395b2a6dcf476b905222023-07-03T08:55:40ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492023-12-0139151151710.1080/11101849.2023.2230404Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients: A randomized double-blinded trialNahla N Shehab0Walaa Y Elsabeeny1Sayed M Abed2Department of Anesthesia, Intensive Care and Pain Management, National Cancer Institute, Cairo University, Cairo, EgyptDepartment of Anesthesia, Intensive Care and Pain Management, National Cancer Institute, Cairo University, Cairo, EgyptDepartment of Anesthesia, Intensive Care and Pain Management, National Cancer Institute, Cairo University, Cairo, EgyptABSTRACTBackground A wide range of drugs are used for sedation in gastrointestinal (GI) endoscopy procedures, including midazolam, dexmedetomidine, and ketamine. Therefore, this study aimed to compare the effects of these drugs in combination with propofol among cancer patients undergoing GI endoscopy.Methods This randomized, double-blinded study was carried out on 75 cancer patients who underwent GI endoscopy. Patients were categorized into three equal groups. Group D: received dexmedetomidine 0.5 µg/kg bolus infusion over 10 min. Group K: received ketamine 0.5 mg/kg. Group M: received midazolam 0.05 mg/kg. With these drugs, 0.5 mg/kg propofol was administered intravenously with incremental 20 mg till achievement of Ramsey sedation score (RSS) 3–4. After that, 0.5 mg/kg propofol boluses were offered for rescue sedation.Results The endoscopy duration was comparable in the three groups. Time of RSS 3–4 achievement and total propofol dose (P < 0.05) were significantly lower in group D and group K compared to group M. Time to eye-opening were significantly lower in groups D, and K compared to group M, with insignificant difference between group K and group D. Moreover, the heart rate (HR) and mean arterial pressure (MAP) of group K at 10 min, 15 min, 20 min, 25 min, and 30 min, and PACU were significantly greater than D and M groups (P < 0.05). Incidence of hypotension and bradycardia were comparable in the three groups.Conclusions In cancer patients who underwent GI endoscopy, dexmedetomidine-propofol and ketamine-propofol had better sedation efficacy [lower achievement time of RSS 3–4, total propofol dose, and eye-opening time] compared to midazolam-propofol group with superior sedative effect of ketamine-propofol than dexmedetomidine-propofol. While ketamine-propofol had more stable HR and MAP.https://www.tandfonline.com/doi/10.1080/11101849.2023.2230404DexmedetomidineketaminemidazolampropofolGI endoscopycancer |
| spellingShingle | Nahla N Shehab Walaa Y Elsabeeny Sayed M Abed Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients: A randomized double-blinded trial Egyptian Journal of Anaesthesia Dexmedetomidine ketamine midazolam propofol GI endoscopy cancer |
| title | Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients: A randomized double-blinded trial |
| title_full | Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients: A randomized double-blinded trial |
| title_fullStr | Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients: A randomized double-blinded trial |
| title_full_unstemmed | Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients: A randomized double-blinded trial |
| title_short | Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients: A randomized double-blinded trial |
| title_sort | safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients a randomized double blinded trial |
| topic | Dexmedetomidine ketamine midazolam propofol GI endoscopy cancer |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2023.2230404 |
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