Fabien Lemoel1, Julie Contenti1,2, Didier Giolito1, Mathieu Boiffier1, Jocelyn Rapp1, Jacques Istria3, Marc Fournier4, François-Xavier Ageron5, Jacques Levraut1,2. 1. Emergency Department, Centre Hospitalier Universitaire de Nice, Nice, France. 2. University of Nice Sophia-Antipolis, School of Medicine, Nice, France. 3. Service d'Aide Médicale Urgente (SAMU), Centre Hospitalier Intercommunal Toulon-La Seyne, Toulon, France. 4. Service d'Aide Médicale Urgente (SAMU), Assistance Publique-Hôpitaux de Marseille, Marseille, France. 5. Service d'Aide Médicale Urgente (SAMU), Centre Hospitalier Annecy Genevois, Annecy, France.
Abstract
OBJECTIVES: The goal of our study was to compare the frequency and severity of recovery reactions between ketamine and ketamine-propofol 1:1 admixture ("ketofol"). METHODS: We performed a multicentric, randomized, double-blind trial in which adult patients received emergency procedural sedations withketamine or ketofol. Our primary outcome was the proportion of unpleasant recovery reactions. Other outcomes were frequency of interventions required by these recovery reactions, rates of respiratory or hemodynamic events, emesis, and satisfaction of patients as well as providers. RESULTS: A total of 152 patients completed the study, 76 in each arm. Compared with ketamine, ketofol determined a 22% reduction in recovery reactions incidence (p < 0.01) and less clinical and pharmacologic interventions required by these reactions. There was no serious adverse event in both groups. Rates in hemodynamic or respiratory events as well as satisfaction scores were similar. Significantly fewer patients experienced emesis with ketofol, with a threefold reduction in incidence compared with ketamine. CONCLUSION: We found a significant reduction in recovery reactions and emesis frequencies among adult patients receiving emergency procedural sedations with ketofol, compared with ketamine.
RCT Entities:
OBJECTIVES: The goal of our study was to compare the frequency and severity of recovery reactions between ketamine and ketamine-propofol 1:1 admixture ("ketofol"). METHODS: We performed a multicentric, randomized, double-blind trial in which adult patients received emergency procedural sedations with ketamine or ketofol. Our primary outcome was the proportion of unpleasant recovery reactions. Other outcomes were frequency of interventions required by these recovery reactions, rates of respiratory or hemodynamic events, emesis, and satisfaction of patients as well as providers. RESULTS: A total of 152 patients completed the study, 76 in each arm. Compared with ketamine, ketofol determined a 22% reduction in recovery reactions incidence (p < 0.01) and less clinical and pharmacologic interventions required by these reactions. There was no serious adverse event in both groups. Rates in hemodynamic or respiratory events as well as satisfaction scores were similar. Significantly fewer patients experienced emesis with ketofol, with a threefold reduction in incidence compared with ketamine. CONCLUSION: We found a significant reduction in recovery reactions and emesis frequencies among adult patients receiving emergency procedural sedations with ketofol, compared with ketamine.
Authors: Thais Dias Midega; Renato Carneiro de Freitas Chaves; Carolina Ashihara; Roger Monteiro Alencar; Verônica Neves Fialho Queiroz; Giovana Roberta Zelezoglo; Luiz Carlos da Silva Vilanova; Guilherme Benfatti Olivato; Ricardo Luiz Cordioli; Bruno de Arruda Bravim; Thiago Domingos Corrêa Journal: Rev Bras Ter Intensiva Date: 2022 Apr-Jun