Comparison between using Ketofol (Ketamine + Propofol) vs. Propofol Alone in Sedation and Anesthesia Procedures

Abstract

Study objective: We compare the frequency of respiratory depression during
Uro-surgery department procedural sedation anesthesia with ketamine plus propofol versus propofol alone. Secondary outcomes are provider satisfaction, sedation quality, and total propofol dose.

Methods: In this randomized, double-blind, placebo-controlled trial, healthy adults undergoing procedural sedation were pretreated with intravenous fentanyl and then randomized to receive either intravenous ketamine(0.5-1) mg/kg or placebo. In both groups, this procedure was immediately followed by intravenous propofol (0.5-1) mg/kg, with repeated doses of 0.5 mg/kg as needed to achieve and maintain sedation. Respiratory depression was defined according to any of 5 predefined markers. Provider satisfaction was scored on a 5-point scale, sedation quality with the Colorado Behavioral Numerical Pain Scale, and propofol dose according to the total number of milligrams of propofol administer.
Results: The incidence of respiratory depression was similar between the ketamine/propofol (22%) propofol-alone (28%) groups, treating physicians and nurses were more satisfied, less propofol was administered, and there was a trend toward better sedation quality.

Conclusion: Compared with procedural sedation with propofol alone, the combination of ketamine and propofol did not reduce the incidence of respiratory depression but resulted in greater provider satisfaction, less propofol administration, and perhaps better sedation quality.