Title:Comparison of the Sedative Effect of Ketamine, Magnesium Sulfate, and
Propofol in Patients Undergoing Upper Gastrointestinal Endoscopy:
Double-Blinded Randomized Clinical Trial
Volume: 22
Issue: 8
Author(s): Hamed Shafiee, Farahnaz Riahipour, Ahmad Hormati, Sajjad Ahmadpour*, Mohammad Amin Habibi, Mostafa Vahedian, Reza Aminnejad and Mohammad Saeidi*
Affiliation:
- Patient Safety Research Center, Clinical Research Institute, Urmia University
of Medical Sciences, Urmia, Iran
- Associated Professor of Anesthesiology and Pain Medicine,
Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
Keywords:
GI endoscopy, sedation, patient satisfaction, magnesium sulfate, ketamine, midazolam, propofol.
Abstract:
Background: Endoscopy provides valuable diagnostic information and intervention therapies
for gastroenterologists. Therefore, various drugs have been used to induce sedation in patients undergoing
endoscopy, whereas none have been considered preferred by endoscopists. In the current
study, we decided to use the combination of magnesium sulfate, ketamine, and their synergistic effects
for creating partial analgesia to increase the satisfaction of endoscopists and patients.
Methods: This study is a Double-Blind Randomized Clinical Trial that investigates the sedative effect
of ketamine, magnesium sulfate, and propofol in endoscopy. Patients were selected from individuals
over 12 years old and with American Society of Anesthesia (ASA) physical status I or II. The study
was performed on 210 patients classified as ASA (I have no underlying disease) or II (with underlying
controlled disease). The whole group was relieved of pain through sedation according to Ramsay criteria,
satisfaction with the operation, duration, recovery, nausea and vomiting, hypotension, and decreased
oxygen saturation were compared.
Results: A total of 155 patients were enrolled in our study, including 51 patients (midazolam and
propofol), 55 patients (midazolam and ketamine), and 49 patients (midazolam and ketamine and magnesium).
The results showed that preoperative heart rate, intraoperative systolic blood pressure, intraoperative
diastolic blood pressure, postoperative heart rate, postoperative systolic blood pressure,
and postoperative heart rate were significantly different between the groups.
Conclusion: The satisfaction of the endoscopic was achieved to a great extent, mainly in the group receiving
midazolam and propofol and in the group receiving midazolam and ketamine. In most cases,
the satisfaction of the endoscopic was acceptable, and the low satisfaction of the endoscopic was more
in the group receiving midazolam. Ketamine and magnesium were observed. The two compounds
midazolam-ketamine, and midazolam-propofol, have a more favorable effect than the combination of
midazolam, ketamine, and magnesium.
