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Adverse effects of propofol sedation are relatively common, such as respiratory and cardiovascular depression. This study was conducted to determine if doxapram, a respiratory stimulant, could be used to reduce the incidence of respiratory depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single-center, prospective randomized double-blind study performed in the endoscopy unit of Helsinki University Central Hospital. 56 patients were randomized in a 1:1 ratio to either receive doxapram as an initial 1\u00a0mg\/kg bolus and an infusion of 1\u00a0mg\/kg\/h (group DOX) or placebo (group P) during propofol sedation for ERCP. Main outcome measures were apneic episodes and hypoxemia (SpO<jats:sub>2<\/jats:sub>\u2009&lt;\u200990%). Mann\u2013Whitney test for continuous variables and Fisher\u2019s exact test for discrete variables were used and mixed effects modeling to take into account repeated measurements on the same subject and comparing both changes within a group as a function of time and between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no statistically significant differences in apneic episodes (<jats:italic>p<\/jats:italic>\u2009=\u20090.18) or hypoxemia (<jats:italic>p<\/jats:italic>\u2009=\u20090.53) between the groups. There was a statistically significant rise in etCO<jats:sub>2<\/jats:sub>levels in both groups, but the rise was smaller in group P. There was a statistically significant rise in Bispectral Index (<jats:italic>p<\/jats:italic>\u2009=\u20090.002) but not modified Observer\u2019s Assessment of Agitation\/Sedation (<jats:italic>p<\/jats:italic>\u2009=\u20090.21) in group P. There were no statistically significant differences in any other measured parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Doxapram was not effective in reducing respiratory depression caused by deep propofol sedation during ERCP. Further studies are warranted using different sedation protocols and dosing regimens.<\/jats:p><jats:p><jats:bold>Clinical trial registration<\/jats:bold>ClinicalTrials.gov ID NCT02171910.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00464-019-07344-2","type":"journal-article","created":{"date-parts":[[2020,1,28]],"date-time":"2020-01-28T22:10:32Z","timestamp":1580249432000},"page":"5477-5483","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Doxapram as an additive to propofol sedation for endoscopic retrograde cholangiopancreatography: a placebo-controlled, randomized, double-blinded study"],"prefix":"10.1007","volume":"34","clinical-trial-number":[{"clinical-trial-number":"nct02171910","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1164-8887","authenticated-orcid":false,"given":"Jarno","family":"Jokelainen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Belozerskikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harri","family":"Mustonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Udd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Kyl\u00e4np\u00e4\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Outi","family":"Lindstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxim","family":"Mazanikov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"P\u00f6yhi\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,28]]},"reference":[{"issue":"8","key":"7344_CR1","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1111\/j.1399-6576.2011.02462.x","volume":"55","author":"H Kapoor","year":"2011","unstructured":"Kapoor H (2011) Anaesthesia for endoscopic retrograde cholangiopancreatography. 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Jokelainen, Belozerskikh, Mustonen, Udd, Kyl\u00e4np\u00e4\u00e4, Lindstr\u00f6m, Mazanikov, and P\u00f6yhi\u00e4 have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}