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Comparison of the efficacy of ketamine– propofol versus sodium thiopental–fentanyl in sedation: a randomised clinical trial
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  • Published on:
    Methodological issues on the sample size used to compare the efficacy of ketamine–propofol and sodium thiopental–fentanyl.

    Dear Editor,

    We read with great interest the EMJ article by Bahreini and colleagues (published August 2020).1 The authors aimed to compare the relative efficacy and side effect profiles of sodium thiopental–fentanyl (TF) and ketamine–propofol (KP) when used for procedural sedation of 96 adult patients prior to undergoing a painful procedure in the emergency department setting. This randomised double-blind clinical trial quantitatively compared recovery time and both patient and provider satisfaction between the two treatment groups. Additionally, the study aimed to assess the prevalence of adverse effects occurring during recovery and patient recall of the procedure. The authors concluded that there was a statistically significant improvement in both patient and provider satisfaction and degree of procedure recall when using KP compared to TF. However, there was no statistically significant difference in recovery time or adverse effects between the treatment groups.

    The authors discussed that the study was not adequately powered to assess the side effect profiles. However, using a systematic review of the effects of KP and propofol, it is possible to make comparisons with the current study regarding the KP side effect profile.2 In all cases, the occurrence of adverse events was greater in those studies included in the systemic review. For example, the POKER study reported that 14% of patients sedated with KP required an airway intervention 3 compared to only...

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    Conflict of Interest:
    None declared.