title: Propofol-ketamine vs propofol-fentanyl for sedation during pediatric upper gastrointestinal endoscopy.
abstract: BACKGROUND
  The aim of this study was to compare the clinical efficacy and safety of propofol-ketamine with propofol-fentanyl in pediatric patients undergoing diagnostic upper gastrointestinal endoscopy (UGIE).
  
  
  METHODS
  This was a prospective, randomized, double blinded comparison of propofol-ketamine with propofol-fentanyl for sedation in patients undergoing elective UGIE. Ninety ASA I-II, aged 1 to 16-year-old patients were included in the study. Heart rate (HR), systolic arterial pressure, peripheral oxygen saturation, respiratory rate (RR) and Ramsey sedation scores of all patients were recorded perioperatively. Patients were randomly assigned to receive either propofol-ketamine (PK; n = 46) or propofol-fentanyl (PF; n = 44). PK group received 1 mg x kg(-1) ketamine + 1.2 mg x kg(-1) propofol, and PF group received 1 microg x kg(-1) fentanyl + 1.2 mg x kg(-1) propofol for sedation induction. Additional propofol (0.5-1 mg x kg(-1)) was administered when a patient showed discomfort in either group.
  
  
  RESULTS
  The number of patients who needed additional propofol in the first minute after sedation induction was eight in Group PK (17%), and 22 in Group PF (50%) (P < 0.01) and those who did not need additional propofol throughout the endoscopy were 14 in Group PK (30%) and three in Group PF (7%) (P < 0.01). HR and RR values after induction in Group PF were significantly lower than Group PK (P < 0.01).
  
  
  CONCLUSIONS
  Both PK and PF combinations provided effective sedation in pediatric patients undergoing UGIE, but the PK combination resulted in stable hemodynamics and deeper sedation though more side effects.
authors.affiliation: Department of Anesthesiology, Erciyes University School of Medicine, Kayseri, Turkey. zeynept@erciyes.edu.tr
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Tosun
authors.forename: Recep
authors.initials: R
authors.lastname: Aksu
authors.forename: Gulen
authors.initials: G
authors.lastname: Guler
authors.forename: Aliye
authors.initials: A
authors.lastname: Esmaoglu
authors.forename: Aynur
authors.initials: A
authors.lastname: Akin
authors.forename: Duran
authors.initials: D
authors.lastname: Aslan
authors.forename: Adem
authors.initials: A
authors.lastname: Boyaci
mesh_terms: D000293:Adolescent; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods*; D004311:Double-Blind Method; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005283:Fentanyl; D006801:Humans; D007223:Infant; D007649:Ketamine; D008297:Male; D015742:Propofol; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D007649:Ketamine; D005283:Fentanyl; D015742:Propofol