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Ketamine has been used in combination with propofol for sedation to provide analgesia and reduce pain on injection of propofol. Researchers evaluated the effectiveness and safety of a 1:1 mixture of 10 mg/mL of ketamine and 10 mg/mL of propofol (ketofol) administered in a single syringe. In a prospective observational study, 728 adults who underwent procedural sedation and analgesia primarily for orthopedic indications at a single emergency department in Canada between 2005 and 2009 received a median dose of 0.7 mg/kg of each of the two agents.
Ketofol was effective in 98% of patients. Median recovery time was 14 minutes (range, 3–50 minutes). Six patients had apnea or hypoxia and responded to stimulation, positioning, or increased oxygen de…