A comparison of fentanyl-propofol with a ketamine-propofol combination for sedation during endometrial biopsy.
OBJECTIVE
The purpose of this study was to compare the clinical activities of ketamine and fentanyl when used in combination with propofol for outpatients undergoing endometrial biopsy. The investigated parameters were respiration, sedation, recovery rate, side effects, time to discharge, and patient satisfaction.


METHODS
Prospective, randomized, double-blind study.


METHODS
University hospital.


METHODS
Forty American Society of Anesthesiologists physical status I and II patients (age range 38-61 years) scheduled for elective endometrial biopsy.


METHODS
Patients received intravenous bolus doses of either fentanyl 1 microg/kg and propofol 1 mg/kg in (group 1 n = 20) or ketamine 0.5 mg/kg and propofol 1 mg/kg in (group 2 n = 20).


METHODS
Heart rate, systolic and diastolic blood pressure, respiratory rate, and peripheral O(2) saturation were monitored in all patients. Depth of sedation was assessed by the Ramsay sedation score. The Aldrete score was used for postoperative recovery evaluation. The time to Aldrete score >/=8, side effects, and time to discharge were recorded.


RESULTS
Respiratory depression was observed in 5 patients from group 1 and 1 patient from group 2, but the difference was not significant (P > .05). Nausea, vertigo, and visual disturbances were more frequent in group 2 (P < .05). The time to Aldrete score >/=8 was similar in the 2 groups (6.2 +/- 3.5 minutes in group 1 and 7.0 +/- 3.1 minutes in group 2); the time to discharge was significantly longer in group 2 (71.2 +/- 9.7 minutes in group 1 and 115.2 +/- 25.6 minutes in group 2). Frequency of patient satisfaction was 95% in group 1 and 60% in group 2.


CONCLUSIONS
Hemodynamic change and degrees of sedation showed that fentanyl-propofol and ketamine-fentanyl combinations can be used safely in patients undergoing endometrial biopsy. However, with regard to side effects and patient satisfaction, the fentanyl-propofol was superior.
Akin
Aynur
A
Department of Anesthesiology, Erciyes University School of Medicine, Kayseri 38039, Turkey. aaynur@erciyes.edu.tr
Guler
Gulen
G
Esmaoglu
Aliye
A
Bedirli
Nurdan
N
Boyaci
Adem
A
D000328:Adult; D000777:Anesthetics / Q000494:pharmacology*; D001706:Biopsy / Q000379:methods; D016292:Procedural Sedation / Q000379:methods*; D004311:Double-Blind Method; D004717:Endometrium / Q000473:pathology; D005260:Female; D005283:Fentanyl / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007649:Ketamine / Q000494:pharmacology*; D008875:Middle Aged; D010045:Outpatients; D017060:Patient Satisfaction; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies
D000777:Anesthetics; D007649:Ketamine; D005283:Fentanyl; D015742:Propofol