Ketamine and Propofol Are Equally Effective for Procedural Sedation in Adults

But propofol is associated with more-rapid recovery and less respiratory depression.

Studies show that propofol is safe and effective for procedural sedation in adults (JW Emerg Med Jan 4 2008, JW Emerg Med Oct 6 2006, JW Emerg Med Feb 14 2006), but research on ketamine has been done primarily in children. In a prospective, randomized, nonblinded trial, researchers compared ketamine and propofol (each administered intravenously at 1 mg/kg followed by 0.5 mg/kg IV every 3 minutes as needed) for sedation in 97 adults undergoing painful procedures in an urban emergency department. Patients with pain were treated with morphine at least 20 minutes before the procedure.

The rate of subclinical respiratory depression (defined as change in end-tidal CO₂ [ETCO₂]>10 mm Hg, oxygen saturation <92%, or absent ETCO₂ waveform) — one part o…

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)