Zaki Hany A, Shallik Nabil, Shaban Eman, Bashir Khalid, Iftikhar Haris, Mohamed Khair Yousra, Abdelrahim Mohammed Gafar, Fayed Mohamed, Hendy Mohamed, Salem Emad El-Din, Elmoheen Amr
Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
Clinical Anesthesia, Weill Cornell Medical College - Qatar, Doha, QAT.
Cureus. 2022 Jul 26;14(7):e27318. doi: 10.7759/cureus.27318. eCollection 2022 Jul.
Procedural sedation and analgesia (PSA) is a treatment approach involving treating patients with agents with dissociative, sedative, or analgesic properties to suppress their consciousness to variable levels. Ketamine and propofol have been used historically for PSA. Because they each have their demerits, it was postulated that combining both drugs (ketofol) would result in a mixture with additive properties and lessen or eliminate the demerits attributed to each drug. The primary objective of this systematic review and meta-analysis is to compare ketamine alone and a combination of ketamine and propofol (ketofol) for procedural sedation and analgesia from an emergency perspective. A systematic search was conducted on published studies from the databases of Scopus, ScienceDirect, PubMed, Google Scholar, APA PsycInfo, and the Cochrane Central Register of Controlled Trial (CENTRAL) until July 2022. The articles that were published on the online databases were authored between January 2007 and 2018. The selected papers were scanned and examined to check whether they met the eligibility criteria for the study. The search produced six articles that were included in the systematic review and meta-analysis. All six articles that passed the eligibility criteria were viable for the analysis. All the trials focused on the effectiveness of ketofol versus ketamine for PSA from an emergency perspective. Ketofol was found to be safe and more effective in comparison to ketamine for PTA.
程序性镇静镇痛（PSA）是一种治疗方法，涉及使用具有解离、镇静或镇痛特性的药物治疗患者，以将其意识抑制到不同水平。氯胺酮和丙泊酚历来被用于PSA。由于它们各自都有缺点，因此推测将两种药物联合使用（氯胺酮-丙泊酚合剂）会产生具有相加特性的混合物，并减少或消除归因于每种药物的缺点。本系统评价和荟萃分析的主要目的是从急诊角度比较单独使用氯胺酮与氯胺酮和丙泊酚联合使用（氯胺酮-丙泊酚合剂）用于程序性镇静镇痛的效果。对Scopus、ScienceDirect、PubMed、谷歌学术、美国心理学会心理学文摘数据库以及考克兰对照试验中心注册库（CENTRAL）等数据库中截至2022年7月发表的研究进行了系统检索。在线数据库上发表的文章发表于2007年1月至2018年之间。对所选论文进行筛选和审查，以检查它们是否符合该研究的纳入标准。检索产生了6篇纳入系统评价和荟萃分析的文章。所有6篇通过纳入标准的文章都适合进行分析。所有试验均从急诊角度关注氯胺酮-丙泊酚合剂与氯胺酮用于PSA的有效性。结果发现，与氯胺酮相比，氯胺酮-丙泊酚合剂用于程序性镇静镇痛更安全、更有效。
