Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Feb;9(1):5-11.
doi: 10.15171/apb.2019.002. Epub 2019 Feb 21.

Using Ketamine and Propofol for Procedural Sedation of Adults in the Emergency Department: A Systematic Review and Meta-Analysis

Morteza Ghojazadeh  1 , Sarvin Sanaie  2 , Seyed Pouya Paknezhad  3 , Sahba-Sadat Faghih  4 , Hassan Soleimanpour  5
Affiliations
Review

Using Ketamine and Propofol for Procedural Sedation of Adults in the Emergency Department: A Systematic Review and Meta-Analysis

Morteza Ghojazadeh et al. Adv Pharm Bull. 2019 Feb.

Abstract

Purpose: Ketamine-propofol combination (ketofol) is being used to provide a safe and effective procedural sedation (PS) in emergency department (ED) and may theoretically have beneficial effects since using lower doses of each drug may result in a reduction of the adverse events of both agents while maintaining optimal conditions for performing procedures. This systematic review was conducted to evaluate the efficacy, advantages and disadvantages of these two drugs for PS. Methods: The PRISMA statement was used for this systematic review. We searched the databases of PubMed, Scopus, ProQuest, Medline (Ovid) from 1990 to August 2017 for randomized clinical trials (RCTs) in which the study population aged ≥18 and was referred to ED. Full-texts of the studies performed in adults that were published in English were reviewed for inclusion. Both authors independently evaluated all studies. Five articles were eligible for the meta-analysis based on their common outcomes. Results: The total number of subjects was 1250, of which 635 were treated with propofol and 615 were treated with ketofol. Although two of the five studies showed a better quality of sedation with ketofol, the other three did not find any significant difference between propofol and ketofol. This systematic review found a lower incidence of respiratory adverse effects in ketofol group than propofol group. Conclusion: Ketamine/propofol mixture (ketofol) has less respiratory adverse effects than propofol alone in ED procedural sedation.

Keywords: Ketamine; Procedural sedation; Propofol.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Figure 2
Figure 2
Figure 3
Figure 3
Figure 4
Figure 4
Figure 5
Figure 5
See this image and copyright information in PMC

References

    1. Soleimanpour H, Mahmoodpoor A, Eftekhari Milani F, Shahsavari Nia K, Mehdizadeh Esfanjani R, Safari S. Effectiveness of oral ketamine, midazolam, and atropine cocktail versus oral diphenhydramine for pediatric sedation in the emergency department. Iran Red Crescent Med J. 2014;16(9):e21366. doi: 10.5812/ircmj.21366. - DOI - PMC - PubMed
    1. Salen P, Grossman M, Grossman M, Milazzo A, Stoltzfus J. A comparison of ketamine versus etomidate for procedural sedation for the reduction of large joint dislocations. Int J Crit Illn Inj Sci. 2016;6(2):79–84. doi: 10.4103/2229-5151.183022. - DOI - PMC - PubMed
    1. Bellolio MF, Gilani WI, Barrionuevo P, Murad MH, Erwin PJ, Anderson JR. et al. Incidence of Adverse Events in Adults Undergoing Procedural Sedation in the Emergency Department: A Systematic Review and Meta-analysis. Acad Emerg Med. 2016;23(2):119–34. doi: 10.1111/acem.12875. - DOI - PMC - PubMed
    1. Falk J, Zed PJ. Etomidate for procedural sedation in the emergency department. Ann Pharmacother. 2004;38(7-8):1272–7. doi: 10.1345/aph.1E008. - DOI - PubMed
    1. Ruth WJ, Burton JH, Bock AJ. Intravenous etomidate for procedural sedation in emergency department patients. Acad Emerg Med. 2001;8(1):13–8. doi: 10.1111/j.1553-2712.2001.tb00539.x. - DOI - PubMed

LinkOut - more resources