2016 Volume 58 Issue 12 Pages 2389-2398
Background:Benzodiazepines are often used for sedation during endoscopic retrograde cholangiopancreatography （ERCP), but may occasionally induce paradoxical reactions such as excessive movement. We evaluated the tolerability and effectiveness of droperidol, fentanyl and ketamine (DFK) cocktail regimen for sedation during ERCP.
Methods:A total of fifty-nine cases underwent ERCP from August 2012 until September 2013. Seventeen cases were sedated with the DKF method and forty-two cases were treated with midazolam and pentazocine (conventional method). Outcome measures were adverse events associated with sedation and the effectiveness of sedation.
Results:There was no significant difference in the incidence rate of decreased SpO2 less than 90% between the DFK method (6%) and conventional method (10%). The occurrence rate of paradoxical reaction (insufficient sedation) in the DFK group was lower than that in the conventional group (0% vs. 19% ; p=0.09). Daily alcohol drinking of over 20g per day was identified as a risk factor for paradoxical reaction. The incidence rate of paradoxical reaction among the daily drinkers was significantly lower in the DFK group than in the conventional group (0% vs. 50% ; p=0.02).
Conclusions:The tolerability of DKF cocktail sedation during ERCP was similar to that of the conventional method. The DFK method would be effective for patients in whom it is difficult to maintain sufficient sedation by the conventional method.
