A Study to Evaluate KM/Propofol versus KM Alone for Procedural Sedation in Children

Kinsara, Abdulrahman Fayez; Almehmadi, Ahmad Abdulaziz M.; Abdulmajid, Turki Jafar; Ashoor, Motaz; Al Saqabi, Qusai Abdullah; Alrzoq, Rakan Abdulrahman; Abulhamail, Badr  Wadee S; Almatrafi, Randa Fahad; Almazrui, Basim Salman W; Alghamdi, Basem Abdullah; Alshammari, Fawaz Sulaiman Ayed

doi:10.12816/0042839

A Study to Evaluate KM/Propofol versus KM Alone for Procedural Sedation in Children

Document Type : Original Article

Authors

¹ King Faisal Hospital Makkah

² Ibn Sina National College

³ Al Immam Abdulrahman Al Faisal Hospital

⁴ King Abdulalziz General Hospital Jeddah Radiology Department

⁵ Al Jouf University

⁶ Imam University

⁷ King Abdulaziz University Hospital

⁸ Al-Noor Specialty Hospital

⁹ GP in Aseer Hospital

¹⁰ GP - Najran University Hospital

¹¹ University of Hail

10.12816/0042839

Abstract

Background: The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication.
Objective: Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED).
Methods: This was a prospective, randomized, single-blinded, controlled trial of KM vs. CoKP in patients between 3 and 21 years of age. The attending physician administered either ketamine 1 mg/kg i.v. or ketamine 0.5 mg/kg and propofol 0.5 mg/kg i.v. The physician could administer up to three additional doses of ketamine (0.5 mg/kg/dose) or ketamine/propofol (0.25 mg/kg/dose of each). Adverse events (e.g., respiratory events, cardiovascular events, unpleasant emergence reactions) were recorded. Secondary outcomes included efficacy, recovery time, and satisfaction scores.
Results: Thirty-two patients were randomized to KM and 29 patients were randomized to CoKP. There was no difference in adverse events or type of adverse event, except nausea was more common in the KM group. Efficacy of PSA was higher in the KM group (99%) compared to the CoKP group (90%). Median recovery time was the same.
Conclusions: We found no significant differences in adverse events between the KM and CoKP groups. While CoKP is a reasonable choice for pediatric PSA, our study did not demonstrate an advantage of this combination over KM.

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