Ketamine-propofol Versus Ketamine Alone for Procedural Sedation in Adults
Ketamine-propofol Versus Ketamine Alone for Procedural Sedation in Adults : a Blinded, Randomized Controlled Trial
Using Ketamine for procedural sedation in adults is often uncomfortable for emergency physicians because of the significant proportion of patients experimenting recovery agitation. The investigators believe that combining propofol to ketamine, the proportion of recovery agitation will be significantly lowered.
The objectives of this double-blinded, randomized controlled trial are to compare the proportion of recovery agitation in adults receiving procedural sedation with ketamine-propofol versus ketamine alone, and to compare the proportion of other classical procedural sedation side-effects and parameters such as respiratory depression, hypotension, sedation duration, time of recovery, procedural failures, and levels of satisfaction.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Nice, France, 06006
- Hôpital St Roch
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 18 years and older
- indication of procedural sedation
Exclusion Criteria:
- allergy to propofol or ketamine
- alcohol or drug intoxication
- altered mental status
- ASA physical status score > 2
- hemodynamic unstability
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Ketamine-propofol
|
K= Kétamine P= Propofol RSS= Ramsay Sedation Score At t0: 0.5 mg/kg of K (0.1 ml/kg of 5 mg/ml K) followed by 0.5 mg/k of P (0.1 ml/kg of 5 mg/ml P). At t0 + 4 min, if needed to obtain an optimal sedation (RSS of 4 or 5): 0.25 mg/kg of K (0.05 ml/kg of 5 mg/ml K) followed by 0.25 mg/kg of P (0.05 ml/kg of 5 mg/ml P). At t0 + 8 min, if needed to obtain an optimal sedation (RSS of 4 or 5): 0.25 mg/kg of K (0.05 ml/kg of 5 mg/ml K) followed by 0.25 mg/kg of P (0.05 ml/kg of 5 mg/ml P). At t0 + 12 min, if maximal doses have been reached (1 mg/kg of K + 1 mg/kg of P) but the optimal sedation has not been obtained, the procedural sedation will be recorded as a failure in the analysis, and the patient will receive another procedural sedation product (at the discretion of the caregiver). |
|
Active Comparator: Ketamine alone
|
K= Ketamine I= Intralipid placebo At t0: 1 mg/kg of K (0.1 ml/kg of 10 mg/ml K), followed by 0.1 ml/kg of I (physical placebo of propofol in the other arm). At t0 + 4 min, if needed to obtain an optimal sedation (Ramsay Sedation Score of 4 or 5): 0.5 mg/kg of K (0.05 ml/kg of 10 mg/ml K), followed by 0.05 ml/kg of I. At t0 + 8 min, if needed to obtain an optimal sedation (Ramsay Sedation Score of 4 or 5): 0.5 mg/kg of K (0.05 ml/kg of 10 mg/ml K), followed by 0.05 ml/kg of I. At t0 + 12 min, if maximal doses have been used (2 mg/kg of K) but the optimal sedation has not been obtained, the procedural sedation will be recorded as a failure in the analysis, and the patient will receive another procedural sedation product (at the discretion of the caregiver). |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportion of recovery agitation
Time Frame: Recovery agitation is noted after procedural sedation for each patient (30 minutes)
|
Patient will be followed during the procedural sedation, for an average time of thirty minutes after the first injection
|
Recovery agitation is noted after procedural sedation for each patient (30 minutes)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time from first injection to optimal sedation
Time Frame: Patient will be followed during the procedural sedation, for an average time of thirty minutes after the first injection (30 minutes)
|
Patient will be followed during the procedural sedation, for an average time of thirty minutes after the first injection (30 minutes)
|
|
|
Proportion of respiratory depression
Time Frame: respiratory depression is assessed during procedural sedation for each patient (30 minutes)
|
Patient will be followed during the procedural sedation, for an average time of thirty minutes after the first injection
|
respiratory depression is assessed during procedural sedation for each patient (30 minutes)
|
|
Proportion of arterial hypotension
Time Frame: Hypotension is assessed during procedural sedation for each patient (30 minutes)
|
Patient will be followed during the procedural sedation, for an average time of thirty minutes after the first injection
|
Hypotension is assessed during procedural sedation for each patient (30 minutes)
|
|
Proportion of vomiting
Time Frame: vomiting is assessed after procedural sedation for each patient (30 minutes)
|
Patient will be followed duriong the procedural sedation, for an average time of thirty minutes after the first injection
|
vomiting is assessed after procedural sedation for each patient (30 minutes)
|
|
Recovery time
Time Frame: Recovery time is assessed after procedural sedation for each patient (30 minutes)
|
Patient will be followed duriong the procedural sedation, for an average time of thirty minutes after the first injection
|
Recovery time is assessed after procedural sedation for each patient (30 minutes)
|
|
Proportion of procedural failures
Time Frame: Procedural failure is noted for each patient if it's happened (30 minutes)
|
Patient will be followed duriong the procedural sedation, for an average time of thirty minutes after the first injection
|
Procedural failure is noted for each patient if it's happened (30 minutes)
|
|
Level of patient's satisfaction
Time Frame: after procedural sedation, patient's satisfaction is recorded (30 minutes)
|
Patient will be followed during the procedural sedation, for an average time of thirty minutes after the first injection
|
after procedural sedation, patient's satisfaction is recorded (30 minutes)
|
|
Level of care giver's satisfaction
Time Frame: after procedural sedation, care giver's satisfaction is recorded (30 minutes)
|
Patient will be followed during the procedural sedation, for an average time of thirty minutes after the first injection
|
after procedural sedation, care giver's satisfaction is recorded (30 minutes)
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Fabien LEMOEL, MD, CHU de Nice, FRANCE
- Study Director: Jacques LEVRAUT, PD, MD, CHU de Nice, FRANCE
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 11-PP-16
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