Propofol vs. Ketofol for Procedural Sedation in the ED

Investigators randomized 573 adults from three emergency departments (EDs) in Australia to receive ketofol (a 1:1 mixture of ketamine and propofol) or propofol prior to a painful procedure. The main outcome was occurrence of a respiratory adverse event requiring intervention.

The study drug was packaged as 20 mL of solution in a syringe; this contained either 100 mg ketamine + 100 mg propofol, or 200 mg propofol. Patients were treated with an initial dose of 0.05 mL/kg and additional as-needed doses of 0.025 mL/kg.

There was no difference in the main outcome between the ketofol and propofol groups (3% and 5%). Patient satisfaction was high in both groups. Severe emergence delirium was uncommon but slightly more likely to occur in the ketofol …