Ketamine-propofol for Peds Fracture Reduction

13 Jul

Advantages of combination

  • increased anesthetic synergy leading to decreased doses,
  • decreased dysphoric emergence from ketamine
  • decreased pain of propofol injection

Pilot study of 20 children with forearm fractures needing closed reduction with procedural sedation

  • showed rapid recovery (average 38 min from time of ketamine injection to suitability for discharge)
  • no clinically significant complications when using 0.5 mg/kg of ketamine followed by 1 mg/kg of propofol

BOTTOM LINE:

  • one small study, but one of many out there
  • ketamine-propofol combo worth considering, need less of either to get a desired effect

Submitted by F. DiFranco.

Reference(s): Sharieff, GQ, et al. Ketamine-propofol combination sedation for fracture reduction in the pediatric emergency department. Pediatric Emergency Care. 23(12):881-884, Dec 2007.; picture

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