Get the Latest Research in the May Annals

Here is a quick look at two articles published in the May issue of Annals of Emergency Medicine. Visit www.annemergmed.com to read the full text.

By McLeod, et al.

What is already known on this topic: It has become popular to combine ketamine and propofol for emergency department procedural sedation; however, it remains unclear whether this is superior to the use of either agent alone.
What question this study addressed: Does the ketamine-propofol combination reduce recovery time or present any other advantages, compared with ketamine alone, for pediatric orthopedic reductions?
What this study adds to our knowledge: In this 136-child, randomized trial, ketamine-propofol sedation time was 3 minutes shorter than ketamine alone, and there was 10% less vomiting. Airway adverse events and unpleasant recovery reactions were similar between groups.
How this is relevant to clinical practice: Combining ketamine and propofol only marginally shortens recovery relative to ketamine alone, but also reduces vomiting.

By David, et al.

What is already known on this topic: It has become popular to combine ketamine and propofol for emergency department procedural sedation; however, it remains unclear whether this is superior to the use of either agent alone.
What question this study addressed: Does the ketamine-propofol combination reduce the risk of respiratory depression, compared with propofol alone?
What this study adds to our knowledge: In this randomized controlled trial of 193 emergency department patients (half adults, half children), the incidence of respiratory depression was similar between ketamine/propofol and propofol alone. Provider satisfaction was greater with ketamine/propofol, but may have been influenced by incomplete blinding.
How this is relevant to clinical practice: The safety parameter of respiratory depression occurs at similar frequency with ketamine/propofol and propofol alone.