Adv Pharm Bull. 2019;9(1): 5-11.
doi: 10.15171/apb.2019.002
PMID: 31011553
PMCID: PMC6468222
Scopus ID: 85065958093
  Abstract View: 2614
  PDF Download: 671

Review Article

Using Ketamine and Propofol for Procedural Sedation of Adults in the Emergency Department: A Systematic Review and Meta-Analysis

Morteza Ghojazadeh 1 ORCID logo, Sarvin Sanaie 2 ORCID logo, Seyed Pouya Paknezhad 3 ORCID logo, Sahba-Sadat Faghih 4 ORCID logo, Hassan Soleimanpour 5* ORCID logo

1 Research Center for Evidence Based Medicine (RCEBM), Tabriz University of Medical Sciences, Tabriz, Iran.
2 Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz.
3 Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, IR Iran.
4 Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
5 Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.


Purpose: Ketamine-propofol combination (ketofol) is being used to provide a safe and effective procedural sedation (PS) in emergency department (ED) and may theoretically have beneficial effects since using lower doses of each drug may result in a reduction of the adverse events of both agents while maintaining optimal conditions for performing procedures. This systematic review was conducted to evaluate the efficacy, advantages and disadvantages of these two drugs for PS.

Methods: The PRISMA statement was used for this systematic review. We searched the databases of PubMed, Scopus, ProQuest, Medline (Ovid) from 1990 to August 2017 for randomized clinical trials (RCTs) in which the study population aged ≥18 and was referred to ED. Full-texts of the studies performed in adults that were published in English were reviewed for inclusion. Both authors independently evaluated all studies. Five articles were eligible for the meta-analysis based on their common outcomes.

Results: The total number of subjects was 1250, of which 635 were treated with propofol and 615 were treated with ketofol. Although two of the five studies showed a better quality of sedation with ketofol, the other three did not find any significant difference between propofol and ketofol. This systematic review found a lower incidence of respiratory adverse effects in ketofol group than propofol group.

Conclusion: Ketamine/propofol mixture (ketofol) has less respiratory adverse effects than propofol alone in ED procedural sedation.

Keywords: Ketamine, Propofol, Procedural sedation
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Submitted: 11 Aug 2018
Revision: 03 Jan 2019
Accepted: 07 Jan 2019
ePublished: 21 Feb 2019
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