Comparison of two sedation protocols on intraocular pressure and hemodynamic responses during colonoscopy

Colonoscopy is one of the most frequently performed interventional endoscopic procedures for diagnosis and treatment. During the procedure, the increase in intraabdominal pressure can cause undesirable spikes in intraocular pressure. In the literature, there are no studies on agent combinations that cause the least effect on intraocular pressure and hemodynamic response in colonoscopic procedures, which are performed more frequently in the elderly, the patient group at the greatest risk for glaucoma. This study aimed to compare ketamine-propofol and ketamine-midazolam protocols in terms of their effects on hemodynamic parameters and intraocular pressure.

The research was a randomized clinical controlled double-blind study. The study was conducted on 60 healthy adults who underwent elective colonoscopy. Ketamin-midazolam and ketamine-propofol combinations were used. Hemodynamic parameters, intraocular pressures at five different times, and the satisfaction levels of the endoscopist and the patient were recorded.

In both groups, there was a statistically significant difference between the pre-procedure intraocular pressure values and the values at the 1st minute of the procedure and at recovery (p<0.05). No statistically significant difference was found between the intraocular pressure values of the study groups at any time point (p>0.05).

Both combinations can be used safely. The combination of ketamine and propofol in subanesthetic doses provides better sedation without disturbing the hemodynamics and is preferable.