Evidence map›Paper›PMID 41387825›Full record

Trial reportScientific reports2025

Combination use of intravenous ketamine-midazolam as a sedative agent in endoscopic retrograde cholangiopancreatography: a randomized control trial.

Rajdave Singh Sadu Singh, Azlanudin Azman, Jegan Thanabalan, Chik Ian, Boo Han Sin, Razman Jarmin, Fahrol Fahmy Jaafar

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06111872 (Combination Use of Intravenous Ketamine-midazolam as a Sedative Agent in Endoscopic Retrograde Cholangiopancreatography ; A Randomized Control Trial), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06111872 phase2completednot on this map

Combination Use of Intravenous Ketamine-midazolam as a Sedative Agent in Endoscopic Retrograde Cholangiopancreatography ; A Randomized Control Trial

TypeinterventionalSponsorNational University of MalaysiaRan2023 to 2024Enrolled90ConditionsCholangitis, Pancreatic Cancer, Choledocholithiasis, Choledochal CystArmsKetamine, Midazolam, Pethidin
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rajdave Singh Sadu SinghDepartment of Surgery, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Cheras, Malaysia. rajdavee.s@gmail.com.
Azlanudin AzmanDepartment of Surgery, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Cheras, Malaysia. drazlan@ppukm.ukm.my.
Jegan ThanabalanDepartment of Surgery, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Cheras, Malaysia.
Chik IanDepartment of Surgery, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Cheras, Malaysia.
Boo Han SinDepartment of Surgery, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Cheras, Malaysia.
Razman JarminDepartment of Surgery, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Cheras, Malaysia.
Fahrol Fahmy JaafarDepartment of Surgery, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Cheras, Malaysia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive endoscopic procedure that 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 ketamine-midazolam or midazolam-pethidine combination. Depth of sedation was measured using the Ramsay sedation scale while the endoscopist and patient satisfaction scores, sedation failure rate, sedation-related 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 of the procedure: scope intubation (RSS 5.6 vs. 4.42, P < 0.001), common bile duct cannulation (RSS 5.87 vs. 4.9, P < 0.001), sphincterotomy (RSS 5.7 vs. 4.95, P < 0.005), and scope withdrawal (RSS 5.71 vs. 4.86, P < 0.01). Both patients (9.19 vs. 7.31, P < 0.001) and endoscopist (4.79 vs. 3.86, P < 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.Clinical trials.gov ID: NCT06111872 (01/11/2023).

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeHypnotics and SedativesKetamineMidazolamAdultAgedFemaleHumansMaleMiddle AgedPatient SatisfactionProspective StudiesSingle-Blind MethodHypnotics and SedativesKetamineMidazolamEmergence reactionEndoscopic retrograde cholangiopancreatography (ERCP)KetamineMidazolamProcedural sedation

Identifiers

PMID41387825
PMCPMC12769659

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.