Comparison of the sedative efficacy of propofol-ketamine combination versus propofol-ketamine plus lidocaine spray in upper endoscopy

Gastrointestinal endoscopy is an essential method for evaluating and treating gastrointestinal disorders. Sedation in endoscopy aims to safely and effectively control pain and anxiety, to provide an appropriate degree of amnesia or to reduce consciousness, and to improve endoscopy, especially in medical cases,always been a critical issue. Propofol is an effective sedative but does not cause adequate analgesia. To overcome the side effects of lidocaine and ketamine in different doses has been used to increase anxiety, sedation and recovery, but different results have been obtained from different studies. Therefore, the aim of this study was to compare the sedative effect of propofol-ketamine with propofol-ketamine with lidocaine spray in endoscopy.

A clinical trial study was performed on 144 patients who were candidates for outpatient endoscopy in the endoscopy ward of Imam Khomeini Hospital and the patients were randomly divided into two groups. After taking the patient's history, in the first group 0.5 kg / mg propofol with 0.5 kg / mg ketamine and in the second groupin the second group, 2 puffs of 10% lidocaine spray equal to 20 mg were sprayed on the oropharynx. Then 0.5 mg / kg propofol and 0.5 mg / kg ketamine were injected. Then sedation, apnea, nausea and clinical findings in patients were evaluated and compared.

In this study, the sex distribution of patients undergoing surgery was 46.75% female and 53.25% male. In this study, the mean age of patients was 49.40 years and the two groups were matched for age and gender. The mean duration of anesthesia was 15.84 minutes and the mean endoscopic duration of patients was 13.34 minutes. There was no significant difference between the distribution of anesthesia duration and endoscopic duration in the two groups. According to the study, sedation was higher among patients receiving propofol, ketamine, and lidocaine spray.There is no significant difference in systolic blood pressure levels between the two groups. Heart rate was significantly lower during the duration of anesthesia in the propofol, ketamine, and lidocaine groups. Blood oxygen levels were significantly higher in the propofol, ketamine and lidocaine group. There is no significant difference between apnea and nausea in patients in the two groups and the recovery time in patients receiving propofol and ketamine and lidocaine is longer than the propofol and ketamine groups.

Adding topical lidocaine spray to the propofol-ketamine drug combination for endoscopic procedures increases the degree of sedation in endoscopy.