Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients: A randomized double-blinded trial

Background A wide range of drugs are used for sedation in gastrointestinal (GI) endoscopy procedures, including midazolam, dexmedetomidine, and ketamine. Therefore, this study aimed to compare the effects these combination with propofol among cancer patients undergoing GI endoscopy.Methods This randomized, double-blinded was carried out on 75 who underwent endoscopy. Patients were categorized into three equal groups. Group D: received dexmedetomidine 0.5 µg/kg bolus infusion over 10 min. K: ketamine mg/kg. M: midazolam 0.05 With drugs, mg/kg administered intravenously incremental 20 mg till achievement Ramsey score (RSS) 3–4. After that, boluses offered rescue sedation.Results The duration comparable Time RSS 3–4 total dose (P < 0.05) significantly lower group D K compared M. eye-opening groups D, M, insignificant difference between D. Moreover, heart rate (HR) mean arterial pressure (MAP) at min, 15 25 30 PACU greater than M 0.05). Incidence hypotension bradycardia groups.Conclusions In endoscopy, dexmedetomidine-propofol ketamine-propofol had better efficacy [lower time 3–4, dose, time] midazolam-propofol superior sedative effect dexmedetomidine-propofol. While more stable HR MAP.