A comparison between magnesium sulphate and fentanyl as adjuvants to propofol infusion for sedation in endoscopic retrograde cholangiopancreatography: A randomized controlled trial

ABSTRACT Background Propofol-based sedations are used widely during endoscopic retrograde cholangiopancreatography (ERCP) procedures. However, respiratory depression and cardiovascular adverse events commonly occur. Therefore, we designed this study to evaluate the effects of adding a single boules induction dose of fentanyl or magnesium sulphate to propofol infusion for sedation of patients subjected to ERCP. Methods This randomized parallel double-blind controlled trial included 60 adult patients scheduled for ERCP procedures. Before starting the propofol infusion, patients immediately received either magnesium sulphate 50 mg.kg−1 intravenously (IV) over 10 min (Group M) (n = 30) or fentanyl 2 µg.kg−1 IV over 10 min (Group F) (n- = 30). Continuous propofol infusion was given with a syringe pump for maintenance, with the initial rate set at 25–75 mic/kg/min IV during the first 10–15 min. Results The magnesium group had significantly reduced the total propofol consumption and increased the onset time of sedation than the fentanyl group (P < 0.05). Heart rate and mean arterial pressure were statistically lower after adjuvant bolus injection and 15 min in the magnesium group than in the fentanyl group (P < 0.001). Procedure time, involuntary movement, physician satisfaction, and complications exhibited no significant differences between both groups. Conclusions During ERCP, adding a single bolus of magnesium sulphate to propofol was associated with a lower total propofol consumption and better hemodynamics than fentanyl but with a delayed onset time of sedation and comparable respiratory depression.