TY - JOUR
T1 - Ketamine-propofol combination (ketofol) vs propofol for procedural sedation and analgesia
T2 - Systematic review and meta-analysis
AU - Jalili, Mohammad
AU - Bahreini, Maryam
AU - Doosti-Irani, Amin
AU - Masoomi, Rasoul
AU - Arbab, Mona
AU - Mirfazaelian, Hadi
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Objective This meta-analysis of trials was conducted to evaluate the analgesic and side effects of ketamine-propofol combination (ketofol) in comparison to propofol in procedural sedation and analgesia (PSA). Methods Medline, EMBASE, Scopus, CINHAL, and Cochrane Central Register of Controlled Trials were searched for clinical trial. The administration complications were the key outcomes of interest. Result Eighteen clinical trials that met our criteria were included in the analysis. Pooling of data showed that ketofol is significantly effective for reduction of respiratory complication and with relative risk (RR) of 0.31 in 14 trials (95% confidence interval [CI], 0.47-0.7; P =.001). Ketofol was also effective in reducing cardiovascular complications with hypotension RR of 0.11 in 9 trials (95% CI, 0.17-0.97; P =.04) and bradycardia RR of 0.47 in 8 trials (95% CI, 0.28-0.72; P =.008). The present study also showed that the summary of RR for psychomimetic complications was 1.95 in 13 trials were (95% CI, 0.79-4.81; P =.15) and for muscle rigidity was 0.52 for 2 trials (95% CI, 0.06-4.67; P =.56), and both were insignificant. In regard to nausea and vomiting, the RR was 1.23 in 12 trials (95% CI, 0.39-3.88; P =.72) and insignificant. Conclusion This meta-analysis demonstrates good safety profile in cardiorespiratory problems and comparable rate of other complications with propofol in adult procedural sedation and analgesia.
AB - Objective This meta-analysis of trials was conducted to evaluate the analgesic and side effects of ketamine-propofol combination (ketofol) in comparison to propofol in procedural sedation and analgesia (PSA). Methods Medline, EMBASE, Scopus, CINHAL, and Cochrane Central Register of Controlled Trials were searched for clinical trial. The administration complications were the key outcomes of interest. Result Eighteen clinical trials that met our criteria were included in the analysis. Pooling of data showed that ketofol is significantly effective for reduction of respiratory complication and with relative risk (RR) of 0.31 in 14 trials (95% confidence interval [CI], 0.47-0.7; P =.001). Ketofol was also effective in reducing cardiovascular complications with hypotension RR of 0.11 in 9 trials (95% CI, 0.17-0.97; P =.04) and bradycardia RR of 0.47 in 8 trials (95% CI, 0.28-0.72; P =.008). The present study also showed that the summary of RR for psychomimetic complications was 1.95 in 13 trials were (95% CI, 0.79-4.81; P =.15) and for muscle rigidity was 0.52 for 2 trials (95% CI, 0.06-4.67; P =.56), and both were insignificant. In regard to nausea and vomiting, the RR was 1.23 in 12 trials (95% CI, 0.39-3.88; P =.72) and insignificant. Conclusion This meta-analysis demonstrates good safety profile in cardiorespiratory problems and comparable rate of other complications with propofol in adult procedural sedation and analgesia.
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U2 - 10.1016/j.ajem.2015.12.074
DO - 10.1016/j.ajem.2015.12.074
M3 - Article
C2 - 26809929
AN - SCOPUS:84955271922
SN - 0735-6757
VL - 34
SP - 558
EP - 569
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 3
ER -