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Article

Procedural Sedation Using a Propofol–Ketamine Combination (Ketofol) vs. Propofol Alone in the Loop Electrosurgical Excision Procedure (LEEP): A Randomized Controlled Trial

by
Chahyun Oh
1,†,
Yeojung Kim
2,†,
Hongsik Eom
2,
Sookyoung Youn
2,
Sangmin Lee
2,
Young-Bok Ko
3,
Heon Jong Yoo
3,
Woosuk Chung
1,2,
ChaeSeong Lim
1,2 and
Boohwi Hong
1,2,*
1
Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon 35015, Korea
2
Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea
3
Department of Obstetrics and Gynecology, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2019, 8(7), 943; https://doi.org/10.3390/jcm8070943
Submission received: 14 May 2019 / Revised: 24 June 2019 / Accepted: 27 June 2019 / Published: 28 June 2019
(This article belongs to the Section Anesthesiology)
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Abstract

Background: Although the loop electrosurgical excision procedure (LEEP) is a brief procedure, it can cause severe pain and discomfort to patients in the absence of adequate sedation. An admixture of ketamine with propofol (ketofol), may reduce patient movement due to insufficient sedation while providing hemodynamic and respiratory stability. This study evaluated the ability of two ratios of a propofol–ketamine combination, compared with propofol alone, to reduce patient movement during procedural sedation for LEEPs. Methods: One hundred and twenty women scheduled for a LEEP were randomly assigned to three groups. Anesthesia was induced with 1 mg/kg propofol (group P), 1 mg/kg propofol and 0.33 mg/kg ketamine (group K1), or 1 mg/kg propofol and 0.66 mg/kg ketamine (group K2). The primary outcome was the incidence of adduction motion in the lower extremities during the procedure. The requirements for respiratory interventions, changes in vital signs, sedation score, additional anesthetic usage, and surgeon and patient satisfaction were also evaluated. Results: The incidence of adduction motion was significantly lower in groups K1 and K2 than in group P (overall p-value <0.001) but did not differ significantly in groups K1 and K2. Group K2 needed more jaw thrust maneuvers than group K1. Additional propofol usage was lower and surgeon satisfaction scores higher in groups K1 and K2 than in group P. Conclusion: A propofol–ketamine combination is more effective than propofol alone in reducing procedural interference during LEEPs. However, increasing the dose of ketamine showed no additional benefit.
Keywords: Sedation; propofol; ketamine; conization; drug combinations Sedation; propofol; ketamine; conization; drug combinations

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MDPI and ACS Style

Oh, C.; Kim, Y.; Eom, H.; Youn, S.; Lee, S.; Ko, Y.-B.; Yoo, H.J.; Chung, W.; Lim, C.; Hong, B. Procedural Sedation Using a Propofol–Ketamine Combination (Ketofol) vs. Propofol Alone in the Loop Electrosurgical Excision Procedure (LEEP): A Randomized Controlled Trial. J. Clin. Med. 2019, 8, 943. https://doi.org/10.3390/jcm8070943

AMA Style

Oh C, Kim Y, Eom H, Youn S, Lee S, Ko Y-B, Yoo HJ, Chung W, Lim C, Hong B. Procedural Sedation Using a Propofol–Ketamine Combination (Ketofol) vs. Propofol Alone in the Loop Electrosurgical Excision Procedure (LEEP): A Randomized Controlled Trial. Journal of Clinical Medicine. 2019; 8(7):943. https://doi.org/10.3390/jcm8070943

Chicago/Turabian Style

Oh, Chahyun, Yeojung Kim, Hongsik Eom, Sookyoung Youn, Sangmin Lee, Young-Bok Ko, Heon Jong Yoo, Woosuk Chung, ChaeSeong Lim, and Boohwi Hong. 2019. "Procedural Sedation Using a Propofol–Ketamine Combination (Ketofol) vs. Propofol Alone in the Loop Electrosurgical Excision Procedure (LEEP): A Randomized Controlled Trial" Journal of Clinical Medicine 8, no. 7: 943. https://doi.org/10.3390/jcm8070943

APA Style

Oh, C., Kim, Y., Eom, H., Youn, S., Lee, S., Ko, Y.-B., Yoo, H. J., Chung, W., Lim, C., & Hong, B. (2019). Procedural Sedation Using a Propofol–Ketamine Combination (Ketofol) vs. Propofol Alone in the Loop Electrosurgical Excision Procedure (LEEP): A Randomized Controlled Trial. Journal of Clinical Medicine, 8(7), 943. https://doi.org/10.3390/jcm8070943

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