Objective To assess the safety and effectiveness of the ketamine plus propofol combination versus propofol alone for procedural sedation in pediatric patients undergoing upper GI endoscopy.
Patients and design: A retrospective case series of patients undergoing procedural sedation for upper GI endoscopy was studied. Median age was 6.3 (0.4–13.1) years. 29 patients received propofol alone while 37 patients received propofol plus ketamine; the child’s degree of sedation was scored using the modified Ramsay sedation scale. Procedural success (length of the procedure), adverse effects, recovery time, and vital signs were also measured.
Results No patient in either group experienced major adverse events or required tracheal intubation. In group receiving ketamine and propofol, the total dose of propofol required was significantly lower than in Propofol alone (3.4.±3.2 mg/kg vs. 5.2±3.4 mg/kg; P<0.001). The incidence of hypotension was also significantly lower (10% vs. 37%; P<0.001). Both best analgesia and shorter recovery time were obtained with the propofol-ketamine association. No differences were observed in the degree of sedation and in the awakening quality score between the two groups.
Conclusions The combination of propofol and ketamine provides a good solution for procedural sedation in during GI endoscopic procedures. Compared to propofol alone, ketamine and propofol results in less hypotension and reduces the incidence of respiratory depression.