Ketofol for Procedural Sedation and Analgesia in the Pediatric Population

Iqbal, Ammarah; Shuster, Megan E; Baum, Carl R.

doi:10.1097/pec.0000000000002599

Cited by 10 publications

(10 citation statements)

References 32 publications

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“…Due to the potential for apnea with propofol, propofol-related respiratory depression occurs frequently reported adverse effects. Ketamine has the unique characteristics of maintaining stable oxygen saturation owing to its ability to exert direct smooth muscle relaxation, bronchodilation effect, and preserve the laryngeal reflex ( Cortinez and Anderson, 2018 ; Iqbal et al, 2022 ). However, it should be noted that ketamine-induced sedation can also result in the adverse airway and respiratory events, with an incidence of 1.4%–6.6% ( Green et al, 2009 ).…”

Section: Discussionmentioning

confidence: 99%

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Effective dose of propofol combined with a low-dose esketamine for gastroscopy in elderly patients: A dose finding study using dixon’s up-and-down method

Zheng¹,

Xu²,

Huang

et al. 2022

Front. Pharmacol.

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Objective: This study aimed to determine the optimal dose of propofol combined with esketamine to inhibit the response to gastroscope insertion in elderly patients.Methods: This is a prospective, non-controlled, non-randomized, single-center study. Elderly patients aged 65–80 years were enrolled in the study with the American society of anesthesiologists (ASA) physical status I or II undergoing elective gastroscopy. All patients were administered propofol after an intravenous esketamine at the dosage of 0.3 mg/kg 30 s, the subsequent dose of propofol was determined by the response of the previous patient to gastroscope insertion (choking, body movement, etc.) using Dixon’s up-and-down method. The initial dose of propofol administered to the first elderly patient was 3.0 mg/kg, and the standard ratio of propofol dose in adjacent patients was 0.9. At least six crossover points were obtained before the conclusion of the study. By using Probit analysis the median effective dose (ED50), 95% effective dose (ED95), and the corresponding 95% confidence interval (CI) for propofol were determined.Results: The study continued until we obtained seven crossover points and 32 elderly patients (17 males and 15 females) were collected. The ED50 of propofol combined with esketamine inhibiting response to gastroscope insertion in elderly patients were found to be 1.479 mg/kg (95% CI 1.331–1.592 mg/kg), and ED95 was found to be 1.738 mg/kg (95% CI 1.614–2.487 mg/kg).Conclusion: According to the present study, propofol combined with 0.3 mg/kg esketamine is safe and effective for elderly patients undergoing gastroscopy. The ED50 and ED95 doses of propofol inhibiting response to gastroscope insertion in elderly patients when combined with 0.3 mg/kg esketamine were 1.479 and 1.738 mg/kg, respectively, without apparent adverse effects.

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Section: Discussionmentioning

confidence: 99%

“…Frontiers in Pharmacology frontiersin.org and preserve the laryngeal reflex (Cortinez and Anderson, 2018;Iqbal et al, 2022). However, it should be noted that ketamineinduced sedation can also result in the adverse airway and respiratory events, with an incidence of 1.4%-6.6% (Green et al, 2009).…”

Section: Figurementioning

confidence: 99%

Effective dose of propofol combined with a low-dose esketamine for gastroscopy in elderly patients: A dose finding study using dixon’s up-and-down method

Zheng¹,

Xu²,

Huang

et al. 2022

Front. Pharmacol.

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“…[ 34 ] The peak effect is usually achieved within 40 to 60 seconds after administration, with a duration of only 10 to 15 minutes, depending on the dosage and serum concentration of the drug. [ 35 ] It inhibits sympathetic nerve activity and baroreceptor reflexes, leading to hemodynamic damage, which can lead to hypotension and bradycardia; It also increases the production of nitric oxide, leading to vasodilation. [ 36 ] Propofol does not produce analgesic effects, therefore opioid or other drugs are needed to control pain.…”

Section: Management Methods and Commonly Used Drugs For Pediatric Den...mentioning

confidence: 99%

The application of drug behavior management methods in the treatment of dental fear and oral diseases in children: A review

Huang,

Yang,

Nie

et al. 2024

Medicine

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Oral behavior management methods include basic behavior management methods and drug behavior management methods. In many cases, dental treatment that cannot be done simply through basic behavior management is not possible. The uncooperative behavior of children with dental fear in oral treatment has increased the demand for medication based behavior management methods. Drug sedation can provide more effective analgesic and anti-anxiety effects, thereby helping to provide comfortable, efficient, and high-quality dental services. This article will review the drug sedation methods selected in clinical treatment of pediatric dental fear in recent years, as well as the safety and effectiveness of commonly used drugs, in order to provide guidance for dental professionals in clinical practice.

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Section: Treatmentmentioning

confidence: 99%

“…A variety of analgesic drugs is available [ 113 , 114 , 115 , 116 , 117 , 118 , 119 ]. Table 6 summarizes the drugs, doses and effects of the most commonly used analgesics in pediatrics [ 98 , 99 , 100 , 101 , 108 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 ]. Pharmacological analgesia in children depends on the procedure, kind and intensity of pain and the age of the patient ( Table 7 ) [ 120 , 121 , 122 ].…”

Section: Treatmentmentioning

confidence: 99%

Evaluation and Treatment of Pain in Fetuses, Neonates and Children

Mencía

Alonso²,

Pallás‐Alonso³

et al. 2022

Children

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The perception of pain is individual and differs between children and adults. The structures required to feel pain are developed at 24 weeks of gestation. However, pain assessment is complicated, especially in neonates, infants and preschool-age children. Clinical scales adapted to age are the most used methods for assessing and monitoring the degree of pain in children. They evaluate several behavioral and/or physiological parameters related to pain. Some monitors detect the physiological changes that occur in association with painful stimuli, but they do not yet have a clear clinical use. Multimodal analgesia is recommended for pain treatment with non-pharmacological and pharmacological interventions. It is necessary to establish pharmacotherapeutic protocols for analgesia adjusted to the acute or chronic, type and intensity of pain, as well as age. The most used analgesics in children are paracetamol, ibuprofen, dipyrone, opioids (morphine and fentanyl) and local anesthetics. Patient-controlled analgesia is an adequate alternative for adolescent and older children in specific situations, such as after surgery. In patients with severe or persistent pain, it is very important to consult with specific pain services.

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Ketofol for Procedural Sedation and Analgesia in the Pediatric Population

Cited by 10 publications

References 32 publications

Effective dose of propofol combined with a low-dose esketamine for gastroscopy in elderly patients: A dose finding study using dixon’s up-and-down method

Effective dose of propofol combined with a low-dose esketamine for gastroscopy in elderly patients: A dose finding study using dixon’s up-and-down method

The application of drug behavior management methods in the treatment of dental fear and oral diseases in children: A review

Evaluation and Treatment of Pain in Fetuses, Neonates and Children

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