Alfentanil versus ketamine combined with propofol for sedation during upper gastrointestinal system endoscopy in morbidly obese patients

OBJECTIVES To observe the effects of both propofol/alfentanil and propofol/ketamine on sedation during upper gastrointestinal system endoscopy in morbidly obese patients (UGSEMOP). METHODS In a prospective, double-blinded, randomized clinical study, 52 patients scheduled for UGSEMOP were assigned to either group A (n=26; 10 µg/kg intravenous [IV] alfentanil) or group K (n=26; 0.5 mg/kg IV ketamine). Each patient was administered 0.7 mg/kg propofol for induction. If it was needed, the patients were administered an additional dose of IV propofol. This study was performed in Sehitkamil State Hospital, Gaziantep, Turkey, between January 2014-2015. Total propofol consumption, time to achieve Modified Aldrete Scores (MAS) of 5 and 10 following the procedure, physician and patient satisfaction scores, and instances of side effects, such as bradycardia and hypotension were recorded. Results: Time to onset of sedation and duration of sedation were both significantly shorter in group A. Patients in group A also required less time to achieve an MAS of 5. Total propofol consumption was significantly lower in group A. CONCLUSION Both propofol/alfentanil and propofol/ketamine combinations provided appropriate hypnosis and analgesia during UGSEMOP. However, propofol consumption was significantly higher using the propofol/ketamine combination.