Are Propofol and Ketofol Interchangeable?

For procedural sedation, the advantage of propofol is its short duration; its disadvantage is dose-related respiratory suppression. The advantage of ketamine is absence of respiratory suppression; its disadvantage is longer duration and emergence dysphoria, especially in adults. Investigators randomized 271 patients undergoing deep sedation to receive propofol, a 1:1 mixture of propofol and ketamine, or a 4:1 mixture of propofol and ketamine.

Emergence phenomena were more common in the group that received more ketamine (occurring in 21% of the 1:1 propofol/ketamine group vs. 8% of the propofol group and 10% of the 4:1 propofol/ketamine group). Respiratory suppression was more common in the groups that received more propofol (e.g., hypoxia in…