Safety of applying midazolam-ketamine-propofol sedation combination under the supervision of endoscopy nurse with patient-controlled analgesia pump in colonoscopy

Table 1 Patient demographic data, n (%)

		Endoscopy Nurse		Anaesthetist		P
		mean ± SD	Median	mean ± SD	Median
Age		53.6 ± 15.5	57.5	59.9 ± 11.8	62.0	0.1131
Sex	Female	18 (60.0)		17 (56.7)		0.7932
	Male	12 (40.0)		13 (43.3)
ASA	I	18 (60.0)		11 (36.7)		0.0712
	II	12 (40.0)		19 (63.3)

¹Mann-Whitney U test;

²Chi-square test. ASA: American statistical association.

Table 2 Propofol consumption, durations (reaching the cecum, operation, and recovery), patient satisfaction, operation re-preference, and recall of the procedure, n (%)

		Endoscopy Nurse		Anaesthetist		P
		mean ± SD	Median	mean ± SD	Median
Propofol consumption dose		83.0 ± 57.1	70.0	59.7 ± 17.5	50.0	0.0141
Reaching the cecum (min)		5.8 ± 4.9	5.5	4.9 ± 2.2	4.0	0.0041
Total operation (min)		13.7 ± 7.2	13.0	9.5 ± 3.6	8.5	0.0221
Eye opening/Recovery (min)		1.6 ± 1.2	1.0	2.0 ± 0.8	2.0	1.0001
VAS		0.5 ± 0.8	0.0	0.5 ± 0.9	0.0	0.8031
Patient Satisfaction	Very good	19 (63.3)		12 (40.0)		0.0982
	Good	10 (33.3)		13 (43.3)
	Not bad	1 (3.3)		5 (16.7)
	Bad	0 (0)		0 (0)
Operation re-preference		30 (100.0)		28 (93.3)		0.4922
Recall of the procedure	(-)	27 (90.0)		27 (90.0)		1.0002
	(+)	3 (10.0)		3 (10.0)

¹Mann-Whitney U test;

²Chi-square test. VAS: Visual analogue scale.

Table 3 Hemodynamic changes during the procedure

		Endoscopy Nurse		Anaesthetist		P1
		mean ± SD	Median	mean ± SD	Median
Pulse (beats per minute)	Baseline	82.8 ± 13.3	82.5	84.2 ± 11.7	85.5	0.673
	1st min	81.4 ± 13.3	79.0	85.7 ± 14.6	84.0	0.251
	2nd min	80.9 ± 13.8	79.0	83.5 ± 17.9	81.0	0.716
	3rd min	80.8 ± 13.5	79.0	80.7 ± 19.2	79.5	0.704
	4th min	81.0 ± 15.3	80.0	80.1 ± 18.5	77.5	0.665
	5th min	81.9 ± 14.6	81.0	80.5 ± 18.8	78.0	0.414
	≥ 8th min	81.1 ± 14.7	78.5	77.5 ± 14.4	75.0	0.336
Systolic blood pressure (mmHg)	Baseline	131.0 ± 20.5	131.5	136.1 ± 22.3	135.0	0.412
	1st min	126.2 ± 17.6	121.0	129.9 ± 19.4	132.5	0.579
	2nd min	124.2 ± 13.6	125.0	125.7 ± 29.5	121.5	0.519
	3rd min	123.4 ± 13.9	122.0	126.5 ± 27.9	123.0	0.952
	4th min	126.5 ± 15.9	125.0	131.8 ± 30.3	129.5	0.448
	5th min	123.8 ± 13.4	122.0	139.3 ± 28.7	141.0	0.014
	≥ 8th min	124.1 ± 17.2	120.5	142.3 ± 26.7	141.0	0.003
Diastolic blood pressure (mmHg)	Baseline	73.2 ± 12.3	70.5	73.4 ± 13.4	74.0	0.871
	1st min	70.6 ± 10.2	69.5	74.7 ± 14.0	74.0	0.183
	2nd min	71.1 ± 11.1	71.0	72.9 ± 18.3	69.0	0.988
	3rd min	71.2 ± 11.1	70.0	76.3 ± 18.2	75.5	0.359
	4th min	72.8 ± 11.1	72.0	78.7 ± 17.9	80.5	0.175
	5th min	69.2 ± 11.5	69.5	81.9 ± 17.2	82.0	0.002
	≥ 8th min	73.2 ± 11.8	70.5	83.4 ± 16.8	82.0	0.005
SpO2	Baseline	96.7 ± 1.9	97.0	94.4 ± 2.7	94.0	0.000
	1st min	96.0 ± 2.8	97.0	94.7 ± 2.4	95.0	0.014
	2nd min	96.5 ± 3.5	97.0	95.3 ± 2.2	95.5	0.071
	3rd min	96.2 ± 2.8	97.0	95.9 ± 2.0	95.5	0.307
	4th min	96.4 ± 2.3	97.0	96.3 ± 1.9	96.0	0.502
	5th min	95.1 ± 5.3	97.0	96.1 ± 1.7	96.0	0.685
	≥ 8th min	96.1 ± 2.3	97.0	96.0 ± 1.4	96.0	0.422

¹Mann-Whitney U test.

Table 4 Side effects experienced by patients during the procedure, n (%)

		Endoscopy Nurse	Anaesthetist	P1
Cardio pulmonary	Hypotension	2 (6.7)	2 (6.7)	1.000
	Bradycardia	1 (3.3)	0 (0.0)	1.000
	Desaturation	4 (13.3)	1 (3.3)	0.161
Other side effects	Nausea and Vomiting	0 (0.0)	0 (0.0)	1.000
	Headache	2 (6.7)	2 (6.7)	1.000

¹Chi-square test.