COMPARISION OF INTRAVENOUS MIDAZOLAM/ KETAMINE WITH DEXMEDETOMIDINE-PROPOFOL COMBINATION FOR SEDOANALGESIA IN ENDOSCOPIC RETROGRADE CHOLANGIO PANCREATOGRAPHY( ERCP) PROCEDURES IN TERTIARY CARE HOSPITAL

Abstract

Background:Endoscopic retrograde cholangiopancreatography (ERCP), often require sedation during the procedure. The most commonly used drugs for this purpose are midazolam and propofol, which are used as sedative and hypnotic agents with minimal analgesic potential. Aims & objectives:Effects of Sedoanalgesia with Midazolam/ ketamine long with Dexmedetomidine nfusion & Rescue propofol alliquotes regimes on hemodynamic and respiratory variables& recovery profile in patients undergoing ERCP. Methods:In this Retrospective observational study adult patients of ASA grade l- lll were enrolled after taking inform consent from patient & their relatives. Premedication was given in form of inj.Midazolam 0.02 mg/kg iv in Group l,.inj ketamine 0.5 mg/kg iv was given in group ll. Inj.Dexmedetomidine ( bolus dose of 1 μg/kg over 10 min) followed by 0.5μg/kg/hour as maintenance in both the groups.intermittent Intravenous Propofol alliquotes was used for maintain BIS 70-80 in both groups. Amount of propofol used during procedure was notified.. Hemodynamic and respiratory variables, recovery time and adverse events were monitored & recorded. Results:The hemodynamic and respiratory variables were similar in both groups. Total propofol consumption was significantly lower in the group ll. (205+/-80 mg vs.155+/-20 mg p < 0.001). The recovery period was shorter in group ll (time to achieve the Aldrete score 9 was 9.0 ±2.2 vs. , 6.2+/-1.1min p < 0.001).Adverse events were comparable between the two groups. Conclusion:Ketamine-Dexmedetomidine combination with propofol may be a safe and useful alternative for sedation for ERCP patients.