Use of Ketamine, Propofol and Their Combination (KETOFOL) For Procedural Sedation in Emergency Department: A Review: Ketamine, Propofol and their combination (Ketofol) for Procedural Sedation

Huma  Nasir; Muhammad Arslan Zahid; Muhammad Saleh; Shafique  Ahmed; Reeba Wirk; Bahram  Khan

doi:10.54393/pjhs.v4i02.539

Authors

Huma Nasir Department of Emergency Medicine, Zia-ud-Din University Hospital, Karachi, Pakistan
Muhammad Arslan Zahid Department of Anesthesia, Agha Khan University Hospital, Karachi, Pakistan
Muhammad Saleh Department of Anesthesia, Jinnah Postgraduate Medical Center, Karachi, Pakistan
Shafique Ahmed Department of Anesthesia, The Indus Hospital and Health Network, Karachi, Pakistan ⁵
Reeba Wirk Department of Anesthesia, Jinnah Postgraduate Medical Center, Karachi, Pakistan
Bahram Khan Department of Anesthesia, The Indus Hospital and Health Network, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i02.539

Keywords:

Emergency Department, Ketofol, Potential Anesthetic, Sedation

Abstract

For Procedural Sedation, sedative and Analgesic agents are frequently used in Emergency Department but titration of anesthetic doses should be performed with care, and patients should be continuously monitored. The use of Ketamine, Propofol and their combination (Ketofol) is in common practice, but there is currently no intravenous anesthetic agent that is ideal. Therefore, this review was conducted to analyze the efficacy as well as the potential side effects of these anesthetic agents during procedural sedation. Method: For this purpose, Medline, EMBASE, CCRCT and CINAHL were searched and systematically analyzed and the meta-analysis included all English-language randomized control trials (RCTs) comparing K-P vs propofol for procedural sedation in ED. The study included the data of ED patients who received procedural sedation for non-elective unpleasant procedures. Results: As a result of the removal of duplicate citations and studies that did not fulfill eligibility requirements, a total of 06 RCTs involving 932 patients (412 in the propofol group and 520 in the K-P group). Very high levels of inter-rater reliability (j = 0.88; 95% CI = 0.68 to 1.0) were found in the final selection of included trials, with 95.2% agreement. Conclusion: Data revealed that the combination of Ketamine with propofol was the most effective anesthetic combination in the larger randomized, prospective studies carried out in the ED that had sufficient power to use the maintenance of vital signs and the success of the procedure as endpoints are still required

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