Efficacy and Safety of Ketamine-Dexmedetomidine Versus Ketamine-Propofol Combination for Periprocedural Sedation : A Systematic Review and Meta-analysis
© 2024. The Author(s)..
PURPOSE OF REVIEW: The combination of ketamine with propofol and dexmedetomidine has gained popularity for sedation and general anesthesia in different populations. In our meta-nalysis, we helped the anesthesiologists to know the efficiency and the efficacy of both combinations in adult and pediatric patients.
METHODS: We searched PubMed, CENTRAL, Web of Science, and Scopus from inception to August 1, 2023. Our outcome parameters for efficacy were recovery time, pain score, and physician satisfaction while for safety were the related cardiorespiratory, neurological, and gastrointestinal adverse events.
RECENT FINDINGS: Twenty-two trials were included with a total of 1429 patients. We found a significantly longer recovery time in the ketadex group of 7.59 min (95% CI, 4.92, 10.26; I2 = 94%) and a significantly less pain score of - 0.72 (95% CI, - 1.10, - 0.34; I2 = 0%). Adults had a significantly better physician satisfaction score with the ketofol group, odds ratio of 0.29 (95% CI, 0.12, 0.71; I2 = 0%). Recovery agitations were higher in the ketofol group with an odds ratio of 0.48 (95% CI, 0.24, 0.98; I2 = 36%). Furthermore, we found a significant difference between the combinations with a higher incidence in the ketadex group with pooled odds ratio of 1.75 (95% CI, 1.06, 2.88; I2 = 15%). Ketadex was associated with lower pain scores, hypoxic events and airway obstruction, and emergence agitation. At the same time, ketofol had much more clinician satisfaction which might be attributed to the shorter recovery time and lower incidence of nausea and vomiting. Therefore, we suppose that ketadex is the better combination in periprocedural sedation for both adult and pediatric patients who are not at greater risk for postoperative nausea and vomiting.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
|---|---|
| Enthalten in: |
Current pain and headache reports - 28(2024), 4 vom: 01. März, Seite 211-227 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Elsaeidy, Ahmed Saad [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
67VB76HONO |
|---|
| Anmerkungen: |
Date Completed 15.03.2024 Date Revised 17.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s11916-023-01208-0 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM367053861 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM367053861 | ||
| 003 | DE-627 | ||
| 005 | 20240317233013.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240114s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s11916-023-01208-0 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1333.xml |
| 035 | |a (DE-627)NLM367053861 | ||
| 035 | |a (NLM)38214834 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Elsaeidy, Ahmed Saad |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Efficacy and Safety of Ketamine-Dexmedetomidine Versus Ketamine-Propofol Combination for Periprocedural Sedation |b A Systematic Review and Meta-analysis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 15.03.2024 | ||
| 500 | |a Date Revised 17.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a PURPOSE OF REVIEW: The combination of ketamine with propofol and dexmedetomidine has gained popularity for sedation and general anesthesia in different populations. In our meta-nalysis, we helped the anesthesiologists to know the efficiency and the efficacy of both combinations in adult and pediatric patients | ||
| 520 | |a METHODS: We searched PubMed, CENTRAL, Web of Science, and Scopus from inception to August 1, 2023. Our outcome parameters for efficacy were recovery time, pain score, and physician satisfaction while for safety were the related cardiorespiratory, neurological, and gastrointestinal adverse events | ||
| 520 | |a RECENT FINDINGS: Twenty-two trials were included with a total of 1429 patients. We found a significantly longer recovery time in the ketadex group of 7.59 min (95% CI, 4.92, 10.26; I2 = 94%) and a significantly less pain score of - 0.72 (95% CI, - 1.10, - 0.34; I2 = 0%). Adults had a significantly better physician satisfaction score with the ketofol group, odds ratio of 0.29 (95% CI, 0.12, 0.71; I2 = 0%). Recovery agitations were higher in the ketofol group with an odds ratio of 0.48 (95% CI, 0.24, 0.98; I2 = 36%). Furthermore, we found a significant difference between the combinations with a higher incidence in the ketadex group with pooled odds ratio of 1.75 (95% CI, 1.06, 2.88; I2 = 15%). Ketadex was associated with lower pain scores, hypoxic events and airway obstruction, and emergence agitation. At the same time, ketofol had much more clinician satisfaction which might be attributed to the shorter recovery time and lower incidence of nausea and vomiting. Therefore, we suppose that ketadex is the better combination in periprocedural sedation for both adult and pediatric patients who are not at greater risk for postoperative nausea and vomiting | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Dexmedetomidine | |
| 650 | 4 | |a Ketadex | |
| 650 | 4 | |a Ketamine | |
| 650 | 4 | |a Ketofol | |
| 650 | 4 | |a Pain | |
| 650 | 4 | |a Propofol | |
| 650 | 4 | |a Sedation | |
| 650 | 7 | |a Propofol |2 NLM | |
| 650 | 7 | |a YI7VU623SF |2 NLM | |
| 650 | 7 | |a Dexmedetomidine |2 NLM | |
| 650 | 7 | |a 67VB76HONO |2 NLM | |
| 650 | 7 | |a Ketamine |2 NLM | |
| 650 | 7 | |a 690G0D6V8H |2 NLM | |
| 650 | 7 | |a Hypnotics and Sedatives |2 NLM | |
| 700 | 1 | |a Ahmad, Aya Hisham Moussa |e verfasserin |4 aut | |
| 700 | 1 | |a Kohaf, Neveen A |e verfasserin |4 aut | |
| 700 | 1 | |a Aboutaleb, Aya |e verfasserin |4 aut | |
| 700 | 1 | |a Kumar, Danisha |e verfasserin |4 aut | |
| 700 | 1 | |a Elsaeidy, Khaled Saad |e verfasserin |4 aut | |
| 700 | 1 | |a Mohamed, Ola Saeed |e verfasserin |4 aut | |
| 700 | 1 | |a Kaye, Alan D |e verfasserin |4 aut | |
| 700 | 1 | |a Shehata, Islam Mohammad |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Current pain and headache reports |d 2001 |g 28(2024), 4 vom: 01. März, Seite 211-227 |w (DE-627)NLM111627923 |x 1534-3081 |7 nnns |
| 773 | 1 | 8 | |g volume:28 |g year:2024 |g number:4 |g day:01 |g month:03 |g pages:211-227 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s11916-023-01208-0 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 28 |j 2024 |e 4 |b 01 |c 03 |h 211-227 | ||