Low-Dose Ketamine and Propofol Combination for Upper Endoscopy in Morbidly Obese Patients

Aim: The purpose of this randomized double-blinded study is to compare the safety and efficacy of two different concentrations of ketofol on the intraoperative hemodynamics, respiration, bispectral index values and post-anesthesia recovery profiles in morbid obese patients undergoing upper GI endoscopy. Subjects and methods: Patients were randomly allocated into two groups, group I (k/p 1/2), no = 50, and group II (k/p 1/4), no = 50, after receiving ethics committee approval and informed patient's consent. Patients in group I received bolus dose of ketamine 0.5 mg/kg + propofol 1 mg/kg, and group II received ketamine 0.25 mg/kg + propofol 1 mg/kg, intravenously in separate syringes (dosed ketamine then propofol). Incremental doses, half the fi rst dose of propofol (0.5 mg/kg) were given to get the desired depth of sedation, modifi ed by aiming at bispectral index (BIS) values between 70–80, and when the sedation was considered as inadequate by the endoscopist. The baseline measurements were obtained just before the administration of the study drugs. The primary outcome was emergence reactions (recovery agitation or hallucination) following the procedure.