A Prospective Evaluation of “Ketofol” (Ketamine/Propofol Combination) for Procedural Sedation and Analgesia in the Emergency Department

Willman, Elaine; Andolfatto, Gary

doi:10.1016/j.annemergmed.2006.08.002

Cited by 218 publications

(184 citation statements)

References 28 publications

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“…Bu amaçla ketaminin propofolle birlikte kullanımı popülerdir. Bu kombinasyon ile daha az propofol kullanımı sağlanarak propofolün yan etkilerinden kaçınılır-ken, ketaminin psikomimetik yan etkileri de azalmakta ve klinik olarak önemli bir solunum depresyonu da görülme-mektedir (9,20). Bu kombinasyon tek enjektörde karıştırıla-rak uygulanabilir (9, 21) ve 1:1 (20), 2:1 (22), 3:1 (15) gibi farklı oranlarda propofol ve ketamin içeriğine sahip olabilir.…”

Section: Discussionunclassified

Comparison of Dexmedetomidine Versus Ketamine-Propofol Combination for Sedation in Cataract Surgery

Yağan¹,

Karakahya²,

Taş³

et al. 2015

Turk J Anesth Reanim

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Objective: The aim of this study is to compare the sedative properties and haemodynamic and respiratory effects of dexmedetomidine and a ketamine-propofol combination (ketofol), which are expected to have minimal effects on spontaneous breathing. Methods:Sixty patients were enrolled in this prospective randomised study. Patients were divided into 2 groups according to the administration of dexmedetomidine (Group D) and ketofol (Group K). Target sedation level was determined as a Ramsay Sedation Score of 3. In Group D, 0.5 mcg kg -1 dexmedetomidine was administered via intravenous route in 10 minutes versus 0.125 mL kg -1 of a solution containing 200 mg propofol and 100 mg ketamine in Group K. Haemodynamic and respiratory effects, postoperative awakening time, analgesic properties and satisfaction levels of the patients and surgeon were assessed.Results: There was a statistically significant decrease in mean arterial pressures following drug administration compared to initial measurements in both groups. However, there was a statistically significant decrease in heart rate only in Group D. There was no significant difference between the two groups regarding respiratory rate and protection of spontaneous respiration. Although the time for Aldrete score to be 9 was 16.1 minutes for Group K, it was 24.9 minutes for Group D, and this difference was statistically significant (p<0.01). There was no significant difference between the two groups regarding adverse effects, pain scores and satisfaction levels of the patients and surgeon.Conclusion: Compared to dexmedetomidine, at similar sedation levels, sedation provided by ketofol enables satisfactory analgesia. Moreover, ketofol has a more rapid onset of action and a shorter recovery period from anaesthesia without causing significant haemodynamic or respiratory adverse effects. Bulgular:Her iki grupta da ortalama arter basınçları ilaç uygulamaları sonrası başlangıç ölçümlerine oranla anlamlı bir azalma gösterdi. Kalp atım hızı ise sadece Grup D'de anlamlı olarak azaldı. Solunum sayısı ve spontan solunumun korunması açısından iki grup arasında fark yoktu. Aldrete puanının 9 olma zamanı Grup K'da 16,1 dk iken Grup D'de 24,9 dk idi ve aralarındaki fark istatistiksel açıdan anlamlıydı (p<0,01). Yan etkiler, ağrı skorları, hasta ve cerrah memnuniyeti açısından gruplar arasında anlamlı farklılık yoktu.Sonuç: Çalışmamız sonucunda ketofol ile oluşturulan sedasyonun deksmedetomidinle karşılaştırıldığında, benzer sedasyon seviyesinde yeterli analjezi sağladığını ve hemodinamik ve solunumsal açıdan önemli bir yan etkiye yol açmaksızın daha kısa etki başlan-gıcı ve daha kısa derlenme süresine sahip olduğunu tespit ettik. 84 Giriş K atarakt cerrahisi ve vitreoretinal cerrahi en sık uygulanan oftalmik cerrahi prosedürlerdir ve genellikle sedasyon eşli-ğinde veya sedasyon olmadan lokal anestezi (LA) altında gerçekleştirilir (1, 2). Sedasyon amacıyla sıklıkla propofol, benzodiyazepinler, opioidler ve bunların kombinasyonları kullanılmaktadır. Katarakt cerrahisi çoğunlukla ileri yaş-t...

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Section: Discussionunclassified

Comparison of Dexmedetomidine Versus Ketamine-Propofol Combination for Sedation in Cataract Surgery

Yağan¹,

Karakahya²,

Taş³

et al. 2015

Turk J Anesth Reanim

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“…Willman et al (20) reported that the use of ketofol was safe for painful procedures in an emergency unit. They obtained minimal adverse effects in their study, and the recovery from these adverse effects required no or minimal intervention or medication.…”

Section: Discussionmentioning

confidence: 99%

Ketamine versus alfentanil combined with propofol for sedation in colonoscopy procedures: A randomized prospective study

Türk¹,

Aydoğmuş²,

Ünsal³

et al. 2015

Turk J Gastroenterol

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Background/Aims: Different drug combinations are used for sedation in colonoscopy procedures. A ketaminepropofol (ketofol) mixture provides effective sedation and has minimal adverse effects. Alfentanil also provides anesthesia for short surgical procedures by incremental injection as an adjunct. However, no study has investigated the use of ketofol compared with an opioid-propofol combination in colonoscopic procedures. Materials and Methods: A total of 70 patients, ASA physical status I-II, scheduled to undergo elective colonoscopy, were enrolled in this prospective randomized study and allocated to two groups. After premedication, sedation induction was performed with 0.5 mg/kg ketamine +1 mg/kg propofol in Group KP, and 10 mg/kg alfentanil +1 mg/kg propofol in Group AP. Propofol was added when required. Demographic data, colonoscopy duration, recovery time, discharge time, mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation, Ramsey Sedation Scale values, colonoscopy patients' satisfaction scores, and complications were recorded. Results: The need for additional propofol doses was significantly higher in Group AP than in Group KP. MAP at minute 1 and 5, Ramsey Sedation Scale at minute 5, and discharge time were significantly higher in Group KP than in Group AP. Additional propofol doses and total propofol dose were significantly lower in Group KP than in Group AP. Conclusion: Ketofol provided better hemodynamic stability and quality of sedation compared with alfentanilpropofol combination in elective colonoscopy, and required fewer additional propofol; however, it prolonged discharge time. Both combinations can safely be used in colonoscopy sedation.

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“…The most commonly used intravenous agent for general anaesthesia or MAC is propofol. Although propofol provides dose-dependant sedation, amnesia and an anxiolytic effect, it requires an additional analgesic agent as it has no analgesic effect [6,7]. It is especially preferred in outpatient surgery, as it provides a short duration of recovery and early discharge from hospital.…”

mentioning

confidence: 99%

Comparison of ketamine-propofol and remifentanil in terms of hemodynamic variables and patient satisfaction during monitored anaesthesia care

Öncül

Gaygusuz²,

Yılmaz³

et al. 2016

Anaesthesiol Intensive Ther

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Background: This study aimed to compare remifentanil and ketamine-propofol in terms of hemodynamic response, duration of recovery and patient satisfaction in operative hysteroscopy cases who underwent monitored anaesthesia care in combination with paracervical block. Methods: Monitored anaesthesia care was used in 60 ASA I-II female patients. The patients were divided into two groups as remifentanil (Group R) and ketamine-propofol (Group K-P). The hemodynamic effects of remifentanil and ketamine-propofol, and duration of recovery were recorded and compared. The patient satisfaction was also recorded and the two groups were compared. Results: Age, body mass, ASA status, duration of anaesthesia and type of surgery were found to be similar between groups. The time of the Aldrete score reaching ≥ 9 was found to be shorter in Group R when compared with Group KP (Group R: 4.1 ± 1.9 min, Group K-P: 6.1 ± 2.6 min) (P < 0.05). The incidence of postoperative nausea and vomiting was found to be significantly higher in the remifentanil group (P ≤ 0.05). When the groups were compared in terms of patient satisfaction, in both groups this was found to be similar. Conclusion: Sedation with remifentanil combined with a paracervical block during monitored anaesthesia care provides early recovery with effective sedation and analgesia in hysteroscopy procedures.

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A Prospective Evaluation of “Ketofol” (Ketamine/Propofol Combination) for Procedural Sedation and Analgesia in the Emergency Department

Cited by 218 publications

References 28 publications

Comparison of Dexmedetomidine Versus Ketamine-Propofol Combination for Sedation in Cataract Surgery

Comparison of Dexmedetomidine Versus Ketamine-Propofol Combination for Sedation in Cataract Surgery

Ketamine versus alfentanil combined with propofol for sedation in colonoscopy procedures: A randomized prospective study

Comparison of ketamine-propofol and remifentanil in terms of hemodynamic variables and patient satisfaction during monitored anaesthesia care

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