Propofol-ketamine and propofol-fentanyl as anesthetic combinations in ambulatory colonoscopy

Background: the best type of sedation/analgesia for gastrointestinal endoscopic procedures is yet to be defined. Among the combinations used are ketamine at subclinical dose with propofol and propofol with fentanyl.Objective: to characterize the use of propofol-ketamine and propofol-fentanyl as inducing agents during ambulatory colonoscopy, in patients treated at the “Dr. Ernesto Guevara de la Serna” Hospital of Las Tunas, between September 2016 and December 2018.Methods: a prospective longitudinal study was carried out with patients undergoing ambulatory colonoscopy, in the aforementioned institution and during the period herein declared. The sample consisted of 300 patients of the 18 to 70 age group with ASA 1 and ASA 2 physical status. They were divided into two groups of 150, one group with anesthetic combination, randomly selected.Results: male patients predominated. The average age was 60.4 years for women and 58.6 years for men; the highest number of cases were classified as ASA 2. With propofol-fentanyl the results were: 40,67 % of patients with bradycardia, 57 % were normotensive, 23 patients (15,33 %) presented less than 94 % of oxygen saturation. With propofol-ketamine the results were: 45,33 % kept a normal heart rate, 65,3 % normotensive, 64 % with complete oxygen saturation and shorter recovery time (at 20 minutes 36 % of the patients recovered). Both anesthetic techniques caused some manifestations such as nausea, vomiting and drowsiness, to a greater extent with propofol-fentanyl.Conclusions: the use of the two anesthetic combinations was characterized in the patients who underwent colonoscopy.</p

The use of ketamine-propofol in therapeutic diagnostic ambulatory colonoscopy

Background: there is no consensus among specialists as to determine the best type of sedation/analgesia for endoscopic gastrointestinal procedures.Objective: to describe the use of the combination of ketamine and propofol as inducing agents in patients who underwent therapeutic diagnostic ambulatory colonoscopy at the "Dr. Ernesto Guevara de la Serna" General Teaching Hospital of Las Tunas, between September 2016 and March 2017.Methods: a longitudinal, prospective study was carried out at the aforementioned hospital and during the period herein declared. The sample consisted of 123 patients of the 18 to 70 age group, with ASA 1 and 2 physical statuses, who underwent colonoscopy using ketofol (ketamine 0,4 mg / kg and propofol 1 mg / Kg).Results: there was prevalence of female patients in 58,53 % and of the 50 to 60 age group (35,2 %). The ASA 2 physical status was the most frequent one (55,4 %). In all patients heart rate values were within normal limits. A slight increase was observed in stage II with respect to stage I, as well as a decrease in stages III and IV, and an increase in stage V. Variation in the mean arterial pressure kept stable in stages I and II, with lower values in stages III, IV and V, without decreasing to pathological figures. At none of the studied moments oxygen desaturation occurred. Rapid anesthetic recovery predominated (79,67 %). 78,86 % of the patients did not report pain. Only sleepiness and nausea were identified as complications.Conclusions: most of the patients to whom ketamine and propofol were applied as induction agents showed hemodynamic stability in terms of blood pressure, heart rate and oxygen saturation. Only sleepiness and nausea were identified as complications.</p