[Drug sedation during digestive tract endoscopy: current trends]

The paper considers whether ketofol, a mixture of ketamine and propofol, may be used for medical sedation. Prerequisites for designing this mixture are identified. The foreign experience with ketofol is analyzed. The authors' study evaluating the clinical efficiency of a ketofol-based sedation procedure during endoscopic interventions into the digestive tract (n=152; 94 males and 58 females) is described. Ketofol was found to reduce the use of drugs and a need for additional analgesia, by exerting a minimum depriming effect on respiration and blood pressure. A ketamine/propofol ratio of 1:4 is optimal for drug sedation at digestive tract endoscopy; with this ratio, ketofol has sufficient analgesic properties and a stabilizing hemodynamic effect. With the higher mass fraction of ketamine in the mixture, its controllability reduces. Overall, the mixture of ketamine and propofol has proved to be a safe and effective sedative; its use provides not only a good position comfort, possible avoidance of opioids, and no effect of ketamine on psychomotor recovery, but also a more controlled sedation than when these agents are used in the same doses alone.