Etomidate-ketamine versus dexmedetomidine-ketamine for entropy-guided procedural sedation during endoscopic retrograde cholangiopancreatography procedures: A randomized single blind study

  Background and Aims The major challenge for the anesthetist in endoscopic retrograde cholangiopancreatography (ERCP) procedures is to provide moderate to deep levels of sedation in prone position with preservation of spontaneous respiratory efforts in shared airway scenario with an endoscopist. Th...

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Published in:Indian journal of gastroenterology 2023-04, Vol.42 (2), p.177-184
Main Authors: Singh, Jagroop, Pathania, Jyoti, Bodh, Vishal, Sharma, Rajesh, Kumar, Rajesh, Sharma, Brij
Format: Article
Language:English
Subjects:
Gastroenterology
Hepatology
Medicine
Medicine & Public Health
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Summary:  Background and Aims The major challenge for the anesthetist in endoscopic retrograde cholangiopancreatography (ERCP) procedures is to provide moderate to deep levels of sedation in prone position with preservation of spontaneous respiratory efforts in shared airway scenario with an endoscopist. These patients have other comorbidities, making them vulnerable to complications during the routinely used sedation with propofol. We compared the entropy-guided efficacy of combination of etomidate-ketamine to dexmedetomidine-ketamine in patients undergoing ERCP. Methods This prospective single blind randomized entropy-guided trial was conducted on 60 patients with etomidate-ketamine in group I ( n  = 30) and dexmedetomidine-ketamine in group II ( n  = 30). The purpose was to compare etomidate-ketamine versus dexmedetomidine-ketamine for ERCP in terms of intraprocedural hemodynamics with desaturation, onset of sedation, recovery time and endoscopist’s satisfaction. Results Hypotension was observed only in six (20%) patients of group II ( p  
ISSN:0254-8860
0975-0711
DOI:10.1007/s12664-022-01326-4