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Table 1 Characteristics of included trials

From: Ketamine-propofol (Ketofol) for procedural sedation and analgesia in children: a systematic review and meta-analysis

Study Intervention Dose of ketofol Dose of control n Age Procedure Outcome
Canpolat 2012 [19] Ketofol vs. ketamine-dexmedetomidine 2 mL ketamine (50 mg/mL) + 8 mL NS
1 mg/kg propofol followed by 1 mg/kg ketamine
Additional 1 mg/kg propofol, if needed
2 mL ketamine (50 mg/mL) + 8 mL NS
0.5 mL dexmedetomidine (50 μg) + 9.5 mL NS
0.5 μg/kg dexmedetomidine followed by 1 mg/kg ketamine
Additional 0.5 μg/kg dexmedetomidine, if needed
60 8 months to 5 years Burn injury dressing 1. Surgeon satisfaction
2. Adverse effects
3. Hemodynamic parameters
Chiaretti 2011 [13] Ketofol vs. propofol 0.5 mg/kg ketamine before propofol injection
2 mg/kg propofol over 2 min
0.5–1 mg/kg additional dose, if required
2 mg/kg bolus over 2 min
0.5–1 mg/kg additional dose, if needed
121 Ketofol: mean (SD): 6.9 (5.4) years
Propofol: mean (SD): 7.3 (5.2) years
Lumbar puncture or bone marrow aspiration 1. Adverse effects
2. Hemodynamic parameters
Joshi 2017 [20] Ketofol vs. dexmedetomidine-ketamine 1 mg/kg propofol, 1 mg/kg ketamine
Maintenance IV infusion of 100 μg/kg/min of propofol and 1 mg/kg/h of ketamine
Additional 0.5 mg/kg ketamine, if needed
1 μg/kg dexmedetomidine IV infusion over 1 min + 1 mg/kg ketamine IV bolus
Maintenance IV infusion of 0.5 μg/kg/h of dexmedetomidine and 1 mg/kg/h of ketamine
Additional 0.5 mg/kg ketamine, if needed
60 1 month to 6 years Cardiac catheterisation procedure 1. Recovery time
2. Hemodynamic parameters
Khutia 2012 [14] Ketofol vs. propofol-fentanyl Ratio 1:2 mixing 1 mL ketamine (50 mg/mL) with 10 mL of 1% propofol (10 mg/mL)
Each mL contains 9 mg propofol: 4.5 mg ketamine
Bolus: 1 mg/kg propofol, 0.5 mg/kg ketamine
Infusion of 50 μg/kg/min
10 mL of 1% propofol mixed with 1 mL NS (9 mg/mL)
1.5 μg/kg fentanyl diluted to 2 mL of NS
Bolus: 1 mg/kg propofol, 1.5 μg/kg fentanyl
Infusion of 50 μg/kg/min
92 3–14 years Reduction of fracture, I&D abscess, wound debridement 1. Recovery time
2. Adverse effects
3. Hemodynamic parameters
Shah 2011 [17] Ketofol vs. ketamine 0.5 mg/kg ketamine + 0.5 mg/kg propofol
Additional 0.5 mg/kg propofol, if needed
1 mg/kg ketamine + intralipid placebo
Additional 0.25 mg/kg ketamine, if needed
140 Median (IQR): 11 (7–14) years Closed manual reduction 1. Recovery time
2. Adverse events
3. Satisfaction
4. Hemodynamic parameters
Schmitz 2018 [15] Ketofol vs. propofol 1 mg/kg ketamine (5%) + 0.5 mg/kg propofol (1%) + 0.03 mL/kg NS
5 mg/kg/h propofol infusion
1 mg/kg propofol (1%) bolus
10 mg/kg/h propofol infusion
351 3 months to 10 years Elective MRI 1. Recovery time
2. Satisfaction
3. Adverse events
4. Hemodynamic parameters
Tewari 2018 [21] Ketofol vs. dexmedetomidine-propofol Bolus: 1 mg/kg ketamine + 2 mg/kg propofol over 10 min
Infusion: 0.5 mg/kg/h ketamine and 4–6 mg/kg/h propofol
Bolus: 1 μg/kg dexmedetomidine and 2 mg/kg propofol over 10 min
Infusion: 0.25–0.75 μg/kg/h dexmedetomidine and 4–6 mg/kg/h propofol
56 7–16 years Congenital acyanotic heart disease considered amenable for device closure 1. Recovery time
2. Adverse effects
Tosun 2007 [16] Ketofol vs. propofol-fentanyl 0.2 mg/kg ketamine + 1.2 mg/kg propofol
Additional 0.5–1 mg/kg propofol, if needed
0.2 μg/kg fentanyl + 1.2 μg/kg propofol
Additional 0.5–1 mg/kg propofol, if needed
90 1–16 years Upper gastrointestinal endoscope 1. Recovery time
2. Adverse effects
3. Hemodynamic parameters
Ulgey 2014 [22] Ketofol vs. dexmedetomidine- propofol 1 mg/kg ketamine + 1 mg/kg propofol
Maintenance: 1 mg/kg/h ketamine and 100 μg/kg/min propofol
Additional 0.5 mg/kg propofol, if needed
1 μg/kg dexmedetomidine for 5 min, 1 mg/kg propofol
Maintenance: 0.5 μg/kg/h dexmedetomidine and 100 μg/kg/min propofol
Additional 0.5 mg/kg propofol, if needed
46 3–14 years Atrial septal defect for transcatheter closure 1. Recovery time
2. Adverse effects
3. Hemodynamic parameters
Weisz 2017 [18] Ketofol vs. ketamine 0.5 mg/kg ketamine and 0.5 mg/kg propofol
3 maximum additional doses of 0.25 mg/kg ketamine and 0.25 mg/kg propofol, if needed
1 mg/kg ketamine
3 maximum additional doses of 0.5 mg/kg ketamine
183 Ketofol: mean (SD): 9.3 (5)
Ketamine: mean (SD): 8.3 (6)
Fracture of dislocation reduction 1. Recovery time
2. Satisfaction
3. Adverse effects
Yalcin 2018 [23] Ketofol vs. ketamine vs. propofol Ratio 1:1, 200 mg propofol (20 mL) + 200 mg ketamine (4 mL)
0.6 mg/kg bolus followed by 40–60 μg/kg/min infusion
4 mL ketamine diluted with NS to 20 mL, 1 mg/kg bolus followed by 50–60 μg/kg/min
2 mg/kg propofol bolus followed by 70–90 μg/kg/min infusion
75 6–12 years Dental treatment 1. Recovery time
2. Adverse effects
3. Hemodynamic parameters