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Prospective Randomized Trial Evaluating Ketamine for Adult Bronchoscopy.

Oren Fruchter¹, Yair Manevich, Uri Carmi

¹*The Pulmonary Department, Wolfson Medical Center, Holon †Sackler Faculty of Medicine ‡Department of Anesthesia §The Pulmonary Division, Rabin Medical Center, Petach Tikva, Tel Aviv University, Tel Aviv, Israel.

Journal of Bronchology & Interventional Pulmonology

|September 29, 2017

Summary

This summary is machine-generated.

Ketamine-propofol-midazolam (KPM) is as safe and effective as fentanyl-propofol-midazolam (FPM) for adult sedation during flexible fiberoptic bronchoscopy (FFB). This study suggests ketamine

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Area of Science:

Pulmonology
Anesthesiology
Critical Care Medicine

Background:

Ketamine is established for pediatric sedation during flexible fiberoptic bronchoscopy (FFB).
Its use in adult FFB sedation is limited due to insufficient safety and efficacy data.
This study addresses the gap in understanding ketamine's role in adult FFB.

Purpose of the Study:

To compare the safety and efficacy of ketamine-propofol-midazolam (KPM) versus fentanyl-propofol-midazolam (FPM) for adult sedation during FFB.
To evaluate respiratory and hemodynamic stability, and patient and operator satisfaction.

Main Methods:

A prospective randomized trial involving 80 adult patients undergoing FFB.
Patients were randomized to receive either KPM or FPM sedation.
Continuous monitoring of vital signs, including transcutaneous carbon dioxide tension (TcPCO2), was performed.

Main Results:

No significant differences were observed in maximal intraprocedural TcPCO2 or minimal oxygen saturation between the KPM and FPM groups.
Sedation-related respiratory or hemodynamic complications were similar in both groups.
Operator and patient satisfaction levels were comparable between the KPM and FPM regimens.

Conclusions:

Ketamine demonstrates comparable safety and efficacy to fentanyl for adult analgesia and sedation in FFB.
Ketamine's lack of hemodynamic suppression and potent bronchodilator properties support its broader adoption for adult FFB sedation.