Objective: The purpose of this systematic review is to determine whether propofol, ketamine, or propofol-ketamine-propofol (ketofol) will more effectively reduce the likelihood of adverse cardiac events, adverse respiratory events, and emergence agitation in children undergoing cardiac procedures requiring sedation.
Method: PubMed, CINAHL, and Google Scholar were searched from 2010 to 2023. Randomized controlled trials comparing propofol versus ketamine-propofol (ketofol) in pediatric procedures were included. Studies including patients 18 years or younger were included. Search terms and key phrases included, propofol, ketamine, propofol-ketamine, ketofol, pediatric sedation, cardiac procedures, adverse cardiac effects, adverse respiratory effects, and pediatric emergence agitation. Studies were critically appraised and cardiac, hemodynamic, and respiratory effects, as well as episodes of emergence delirium were extracted from each randomized controlled trial.
Results: Five studies met inclusion criteria as they compared propofol and ketofol use during pediatric procedures. The search criteria and inclusion was expanded due to the lack of research comparing propofol and ketofol during pediatric cardiac procedures. Five studies comparing propofol and ketofol in pediatric anesthesia procedures were included.
Conclusions: Findings indicate further research needs to be conducted to determine the safest anesthetic to utilize during pediatric procedures, including those that are cardiac-related.
