Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients

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safety-and-efficacy-of-dexmedetomidine-vs-ketamine-vs-midazolam-combined-with-propofol-in-gastrointestinal-endoscopy-for-cancer-patients

In cancer patients who underwent GI endoscopy, dexmedetomidine-propofol and ketamine-propofol had better sedation efficacy [lower achievement time of RSS 3–4, total propofol dose, and eye-opening time] compared to midazolam-propofol group with superior sedative effect of ketamine-propofol than dexmedetomidine-propofol. While ketamine-propofol had more stable HR and MAP.

The endoscopy duration was comparable in the three groups.

Time of RSS 3–4 achievement and total propofol dose (P < 0.05) were significantly lower in group D and group K compared to group M. Time to eye-opening were significantly lower in groups D, and K compared to group M, with insignificant difference between group K and group D. Moreover, the heart rate (HR) and mean arterial pressure (MAP) of group K at 10 min, 15 min, 20 min, 25 min, and 30 min, and PACU were significantly greater than D and M groups (P < 0.05). Incidence of hypotension and bradycardia were comparable in the three groups.

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