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Comparing ketofol with etofen in procedural sedation analgesia for anterior shoulder dislocation reduction: A
Mojtaba Habibi-Khorasani1, Masoomeh Nazemi-Rafi1, Amirhossein Mirafzal1
1Department of Emergency Medicine, School of Medicine, Kerman University of Medical Sciences, Kerman, , Iran.
Background:
Anterior shoulder dislocations are common in emergency settings, requiring effective procedural sedation and analgesia (PSA). Ketofol (ketamine-propofol) and etofen (etomidate-fentanyl) are widely used, but their comparative efficacy remains debated.
Objectives:
The aim of this study was to compare the efficacy and safety of ketofol versus etofen for PSA in shoulder dislocation reduction.
Methods:
This randomized clinical trial enrolled 92 patients (46 per group). Ketofol (0.75 mg/kg) or etofen (0.15 mg/kg etomidate + 1.5 µg/kg fentanyl) was administered. Outcomes included sedation depth, hemodynamics, adverse events, and recovery times.
Results:
Ketofol provided deeper sedation (RSS 4.5 vs. 4.1, p < 0.001), better analgesia (VAS 1.64 vs. 2.64, p < 0.001), and easier reduction but had more emergence reactions. Etofen showed faster onset and fewer respiratory events but caused myoclonus.
Conclusion:
Ketofol offers superior analgesia and sedation, while etofen ensures rapid recovery and hemodynamic stability. The choice depends on clinical priorities.
Clinical Trial Registration:
IRCT20220824055790N1.
