[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-440989-105":59,"doc-detail-440989-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","combination-use-of-intravenous-ketamine-midazolam-as-a-sedative-agent-in-endoscopic-retrograde-cholangiopancreatography-a-randomized-control-trial","Combination use of intravenous ketamine-midazolam as a sedative agent in endoscopic retrograde cholangiopancreatography: a randomized control trial","","Combination intravenous ketamine-midazolam is evaluated as a sedative strategy for endoscopic retrograde cholangiopancreatography (ERCP), which requires deep sedation to support invasive endoscopic work. This prospective single-blinded randomized control trial compared ketamine-midazolam versus a midazolam-pethidine combination, assessing sedation depth using the Ramsay scale and tracking endoscopist and patient satisfaction, failure rates, and sedation-related complications. In 85 patients, ketamine-midazolam achieved significantly deeper sedation across key ERCP stages and higher satisfaction, suggesting a potentially safer, more effective alternative based on ketamine’s respiratory and hemodynamic profile and combined sedative-analgesic effects.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/combination-use-of-intravenous-ketamine-midazolam-as-a-sedative-agent-in-endoscopic-retrograde-cholangiopancreatography-a-randomized-control-trial/440989/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/combination-use-of-intravenous-ketamine-midazolam-as-a-sedative-agent-in-endoscopic-retrograde-cholangiopancreatography-a-randomized-control-trial/440989.png","ImageObject",300,407,{"name":92,"@type":93},"Aria","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the purpose of combining intravenous ketamine and midazolam for ERCP?","Question",{"text":113,"@type":114},"The study evaluates whether ketamine-midazolam provides effective deep sedation during ERCP and measures sedation depth and related outcomes such as satisfaction and failure rates.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was sedation depth measured in the randomized trial?",{"text":118,"@type":114},"Sedation depth was measured using the Ramsay sedation scale during different stages of the ERCP procedure.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the key findings comparing ketamine-midazolam with midazolam-pethidine?",{"text":122,"@type":114},"Ketamine-midazolam produced significantly deeper sedation at multiple ERCP stages and resulted in higher satisfaction scores for both patients and endoscopists.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},440989,1790718835,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","[www. nature.com/scientificreports](www. nature.com/scientificreports)  \nOPEN  \nCombination use of intravenous ketamine-midazolam as a sedative agent in endoscopic retrograde cholangiopancreatography: a randomized control trial  \nRajdave Singh Sadu Singh1,2􀀍, Azlanudin Azman1􀀍, Jegan Thanabalan1, Chik Ian1, Boo Han Sin1, Razman Jarmin1 & Fahrol Fahmy Jaafar1  \nEndoscopic retrograde cholangiopancreatography (ERCP) is an invasive endoscopic procedure  \nthat requires deep sedation of the patient. Propofol is the most widely used sedative for advanced endoscopic procedures. However, its use is constrained by high cost and the need for administration by an anaesthetist. Our study aims evaluate the efficacy of ketamine-midazolam as a sedative agent during ERCP, assessing the depth of sedation. This prospective single-blinded randomized control trial (RCT) including patients undergoing ERCP. Patients were randomly assigned to either ketaminemidazolam or midazolam-pethidine combination. Depth of sedation was measured using the Ramsay sedation scale while the endoscopist and patient satisfaction scores, sedation failure rate, sedationrelated complication, sedation failure were systematically recorded. A total of 85 patients were included in this study, with 42 in the intervention arm and 43 in controlled arm. The intervention group demonstrated significantly deeper sedation at various stages ofthe procedure: scope intubation (RSS 5.6 vs. 4.42, P \u003C 0.001), common bile duct cannulation (RSS 5.87 vs. 4.9, P \u003C 0.001), sphincterotomy (RSS 5.7 vs. 4.95, P \u003C 0.005), and scope withdrawal (RSS 5.71 vs. 4.86, P \u003C 0.01). Both patients (9.19 vs. 7.31, P \u003C 0.001) and endoscopist (4.79 vs. 3.86, P \u003C 0.001) reported higher satisfaction scores in the ketamine-midazolam group. The combination of ketamine-midazolam offers a potentially safer and more effective sedation strategy compared to midazolam and pethidine for procedural sedation. This is primarily attributed to ketamine’s favourable respiratory and hemodynamic profile along with its combined sedative and analgesic effects.  \nClinical [trials.gov](trials.gov) ID: NCT06111872 (01/11/2023) .  \nKeywords Endoscopic retrograde cholangiopancreatography (ERCP), Ketamine, Midazolam, Procedural sedation, Emergence reaction  \nEndoscopic retrograde cholangiopancreatography (ERCP) is an invasive endoscopic procedure that requires deep sedation of the patient. Since its introduction in 1986, it has gained wide acceptance; it was accepted as a safe, direct technique for evaluating pancreaticobiliary disease1. It was created as a result of significant advancements in flexible endoscopic technology. ERCP is primarily used to diagnose and treat diseases affecting the hepatopancreatobiliary tract.  \nAn appropriate sedative agent increases the likelihood of a successful ERCP procedure2 There are two choices of anaesthesia available for the completion of ERCP: Procedural sedation and general anaesthesia. Procedural sedation is frequently used during ERCP to help the endoscopist accomplish the procedure with minimal patient disruptions. There has been discussion about which sedative should be utilized to produce procedural sedation during ERCP. In general, the best sedative for a procedure should be quick to the onset ofaction, can be titrated, has a high clearance rate, with side effects, can induce amnesia, and with reversible effects.  \n1Department of Surgery, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Cheras, Malaysia.  \n2Department of Surgery, Hospital AngkatanTenteraTuanku Mizan, Wangsa Maju, Kuala Lumpur, Malaysia. 􀀍 email: [rajdavee.s@gmail.com](rajdavee.s@gmail.com); [drazlan@ppukm.ukm.my](drazlan@ppukm.ukm.my)  \n[www. nature.com/scientificreports/](www. nature.com/scientificreports/)  \nMidazolam, often used in combination with pethidine as the first-line option for procedural sedation, has been associated with a significant probability of sedation failure. Literature indicates that th","cbCaikZ7DhlkB4GY","https://ap.wps.com/l/cbCaikZ7DhlkB4GY","pdf",1414980,"English","# Background and rationale\n## ERCP and the need for deep sedation\n## Sedative choices: procedural sedation vs general anaesthesia\n\n# Study design and methods\n## Trial type and grouping\n## Sedation assessment and outcome measures\n\n# Results\n## Sedation depth across ERCP stages\n## Satisfaction outcomes\n\n# Discussion and clinical implications\n## Safety and efficacy versus midazolam-pethidine and propofol","[{\"question\":\"What is the purpose of combining intravenous ketamine and midazolam for ERCP?\",\"answer\":\"The study evaluates whether ketamine-midazolam provides effective deep sedation during ERCP and measures sedation depth and related outcomes such as satisfaction and failure rates.\"},{\"question\":\"How was sedation depth measured in the randomized trial?\",\"answer\":\"Sedation depth was measured using the Ramsay sedation scale during different stages of the ERCP procedure.\"},{\"question\":\"What were the key findings comparing ketamine-midazolam with midazolam-pethidine?\",\"answer\":\"Ketamine-midazolam produced significantly deeper sedation at multiple ERCP stages and resulted in higher satisfaction scores for both patients and endoscopists.\"}]","Combination use of intravenous ketamine-midazolam as a sedative agent in endoscopic retrograde cholangiopancreatography: a randomized control trial | PDF",1790694187,25]