Objectives: Ketofol is used to refer to the name of combination of Ketamine and Propofol. Usage of combination of ketamine, dissociative anesthetic, and propofol, an intravenous anesthetic, in procedural sedation and analgesia has been recently mentioned in several studies as a safer alternative than using only propofol. However, optimal combination and infusion rate of ketofol is still not determined.  In this study, we aimed to determine an optimal combination of ketofol for patients who are going to have circumcision surgery by comparing sedation quality and side effects of two different concentrations of ketofol.


Methods:  Retrospective analyses of sedation level during circumcision surgeries were performed using data from administration of 2 different concentrations of ketofol to patients.  We looked at 102 patients who underwent circumcision surgery.  The patients' ages ranged from 1 to 10. In Group A, patients received a combination of ketamine - propofol  (1:2)(0.5mg/kg-1.0mg/kg). In Group B, patients received a combination of ketamine - propofol  (1:3)(0.5mg/kg-1.5mg/kg). We used  Richmond Agitation and Sedation Scale (RASS) to determine sedation levels.   We recorded surgery duration time, recovery time, systolic blood pressure, diastolic blood pressure, heart rate, O2sat, and any side effects such as , vomiting, coughing, hallucination and apnoea. In addition, RASS levels and the need for  re-application of ketofol injection have also been recorded.  

Conclusion and clinical relevance: In both groups, the demographic characteristics, such as age and weight, were similar. We didn't find any significant change in hemodynamic parameters in both groups.  However, there was a decrease in the number of hallucinations observed in the group that received a higher concentration of ketofol (ketamine/propofol of 1:3). In Group I (1:2)(0.5mg/kg-1.0mg/kg), we found that the number of anesthetic dose repetition was higher. In conclusion, since the number of hallucinations and the need for anesthetic dose repetition were lower in Group II patients, we believe that the concentration of ketofol (1:3)(0.5mg/kg-1.5mg/kg) is more appropriate for procedural sedation and analgesia in circumcision surgeries.

02 / The comparison of two different concentrations of ketofol for pediatric procedural sedation in circumcision surgeries.