Propofol-fentanyl versus propofol-ketamine for procedural sedation and analgesia in patients with trauma

136 trauma patients from the emergency room were randomized to receive either propofol-fentanyl or propofol-ketamine for procedural sedation and analgesia (PSA). Follow up was conducted at 5, 15, 30, and 120 minutes post PSA administration. The primary outcomes of the study were depth of sedation and pain score (VAS); secondary outcomes included blood pressure, heart rate, respiratory rate, O2 saturation, respiratory intervention, physician satisfaction and recovery time. Results of the study revealed significantly better analgesic outcomes in the PF group compared to the PK group. Furthermore, sedation was found to be significantly stronger in the PF group compared to the PK group at 15 minutes. Several secondary outcomes (heart rate, O2 saturation, blood pressure) were were statistically unfavourable in the PF group compared to the PK group, particularly at early time points, and suggest that PF use may have increased side effects compared to PK.