2Selçuk Üniversitesi Meram Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı KONYA Introduction: In this study, we evaluated the effectiveness and safety of intravenous propofol- fentanyl and ketamine-midazolam combinations for procedural sedation and analgesia in elderly patients undergoing urological endoscopic surgery.
Materials and Method: This prospective study enrolled 80 patients aged 60-80 years ASA I-III requiring endoscopic urological procedures. Patients received intravenous bolus doses of either fentanyl 1 μg.kg-1 and propofol 1-2 mg.kg-1 in group P or ketamine 1-1.5 mg.kg-1 and midazolam 0.1 mg.kg-1 in group K titrated according to Ramsay sedation scale in the range of 3-4.
Results: There were no differences in vital signs, operating times and demographic variables. Time to Aldrete score ≥8 was similar in two groups. Time to PADSS ≥9 was significantly longer in group K than group P (p<0.05). The frequency of vertigo, nausea, vomiting, visual disturbances, laryngeal spasm and hallucinations were higher in group K (p<0.05). But pain of injection and respiratory depression were more frequent in group P (p<0.05). Excessive salivation, tachycardia, bradycardia, hypotension, hypertension were similar in both groups.
Conclusion: Hemodynamic changes and degrees of sedation showed that propofol-fentanyl and ketamine-midazolam combinations can safely be used in geriatric patients undergoing endoscopic urological procedures. However, in the propofol-fentanyl group the incidence of side effects were lower and the recovery period was shorter than the ketamine-midazolam group.
Keywords : Propofol; Ketamine; Conscious Sedation ;Geriatrics