The aim of this work is to study the effects, adverse effects and recovery time of IV mixed propofol and ketamine (ketofol) in 3:1 ratio as a sedative analgesic in children with acute lymphoblastic leukemia undergoing bone marrow aspiration.
Methods:
This was a prospective, observational pilot study of twenty patients; 3-12 years with ALL requiring sedation for BMA were included. Mixture of ketofol (3:1) was administered intravenously. Patient satisfaction was the primary outcome in our study. Faces pain scale – revised (FPS-R) was used to assess the degree of analgesia. Secondary outcomes included sedation time, recovery time, adverse events and safety.
Results
The median dose of ketofol is 3 mg/kg of propofol and 1 mg/kg of ketamine. The median score on the pain faces scale was 2 (1-3; 95%CI 1.08-2.92). Median recovery time was 22 minutes (16-30; 95%CI 14.08-29.32). The cardiorespiratory adverse events were transient, tolerable and easily corrected.
Conclusion

Combination of ketamine and propofol produced effective analgesic sedation with rapid recovery and absence of clinically significant adverse events among children requiring procedural sedation and analgesia for bone marrow aspiration. A high recommendation of using large sample size should be considered for further assessment and verification of our results.