Ketofol Compares Favorably to Midazolam/Fentanyl for Procedural Sedation and Analgesia

Ketofol, a 1:1 mixture of ketamine and propofol, is a recent addition to the pharmaceutical armamentarium for procedural sedation and analgesia (PSA). In a prospective randomized trial, 62 adults (age range, 20–37) who required PSA for traumatic injuries at a single emergency department in Iran received either ketofol or a combination of midazolam and fentanyl.

Median doses were 1.125 mg/kg of ketofol and 0.04 mg/kg of midazolam with 2 μg/kg of fentanyl. Mean total sedation times were similar in the two groups (25.1 and 26.1 minutes). Although sedation was deeper with ketofol than with midazolam/fentanyl, only one patient in each group needed bag-mask–assisted ventilation, and no patient required intubation. Perceived pain was significantly …