Analgesia During Propofol Sedation: Ketamine Is Safer Than Fentanyl

Use of ketamine as an adjunct analgesic agent was associated with fewer adverse events, especially desaturation.

Propofol is a rapid-acting, potent sedative that has gained popularity as an agent for procedural sedation and analgesia (PSA) in the emergency department, especially for deep sedation. Because propofol is not an analgesic, additional medication is often indicated for pain, but opioids, such as fentanyl, can increase the risk for respiratory depression. Ketamine causes minimal respiratory depression and, at doses lower than those used for sedation, has analgesic effects. These authors compared adverse events during propofol sedation when fentanyl or ketamine was used for analgesia.

Sixty-three patients (age range, 14–65 years) with painful conditions requiring PSA were randomized to receive either intravenous ketamine (0.3 mg/kg) or fentanyl…

Reviewing Author

Diane M. Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)

Diane M. Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)