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Table 3 Summary of Findings for Comparison between Ketofol and Combined Agents

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

Ketofol compared to a combined agent for procedural sedation and analgesia
Patient or population: Procedural Sedation and Analgesia
Intervention: Ketofol
Comparison: Combined agent
Outcomes Anticipated absolute effects* (95% CI) Relative effect (95% CI) No. of participants (studies) Certainty of the evidence (GRADE)
Risk with combined agent Risk with ketofol
Recovery time The mean recovery time was 0 MD 0.75 higher (6.24 lower to 7.74 higher) 404 (6 RCTs) MODERATE a
Recovery time - Dosage ratio 1:1 The mean recovery time - Dosage ratio 1:1 was 0 MD 7.95 lower (21.86 lower to 5.96 higher) 166 (3 RCTs) LOW b c
Recovery time - Dosage ratio 1:2 The mean recovery time - Dosage ratio 1:2 was 0 MD 14.62 higher (11.09 lower to 40.33 higher) 148 (2 RCTs) LOW b c
Desaturation Study population RR 1.90 (0.15 to 23.60) 150 (2 RCTs) LOW a c
54 per 1000 103 per 1000 (8 to 1000)
Respiratory depression Study population RR 1.98 (0.18 to 21.94) 116 (2 RCTs) LOW a c
68 per 1000 134 per 1000 (12 to 1000)
Hypotension Study population RR 0.42 (0.20 to 0.85) 208 (3 RCTs) MODERATE c
194 per 1000 82 per 1000 (39 to 165)
Bradycardia Study population RR 0.70 (0.14 to 3.63) 298 (4 RCTs) LOW a c
109 per 1000 76 per 1000 (15 to 395)
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; MD: Mean difference; RR: Risk ratio.
GRADE (Working Group grades of evidence)
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate certainty: We are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: Our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.
  1. Footnote:
  2. a Results show large heterogeneity that can be due to the following: 1) different populations: some procedures required a longer duration of treatment, thus, larger doses are required. 2) different ratios of the mixture and dosages of the combination
  3. b Results show large heterogeneity that can be due to different populations and durations of procedures that determine the required dose of intervention
  4. c Small sample size