Propofol or Ketofol for Procedural Sedation and Analgesia in Emergency Medicine: The POKER Study

Ferguson (@ketaminest) et al. Ann Emerg Med 2016; 68:574-582. doi:10.1016/j.annemergmed.2016.05.024

Clinical Question

• In adult Emergency Department patients requiring intravenous sedation for noxious procedures, does a combination of propofol and ketamine (ketofol), compared with single-agent propofol, cause fewer adverse respiratory events?

N = 591, 3 EDs in Australia

Authors’ Conclusions

• Adult procedural sedation using ketofol versus propofol alone results in similar frequency of adverse respiratory events requiring intervention. Propofol was associated with a slightly higher incidence of hypotension, which is of dubious clinical consequence, and patients were highly satisfied with both agents

The Bottom Line

• This study suggests that ketofol and propofol are equally safe, with regards to respiratory complications, for procedural sedation in the emergency department, providing that patients receive adequate analgesia and are sedated using an appropriate protocol.
• Clinicians should continue to use the agent that they are most familiar with.