Episode 87.0 – Journal Review (Ketorlac Dosing + POKER Trial)

Show Notes

Take Home Points

1. The POKER trial examined the difference between propofol and ketofol when it comes to adverse respiratory events.  They found no significant difference between the groups.  Given the increased risk of medication errors using two medication instead of one, you may want to avoid the mixture.
2. Ketorolac has an analgesic ceiling effect lower than you may have thought.  When comparing IV doses of 10mg, 15mg and 30mg they found no difference in analgesic effect.  Given the risks of side effects may increase with higher doses, you may want to stick to the lower 10mg dose.

RebelEM: The POKER Trial: Go All in on Ketofol?

St. Emlyn’s: JC: Is Ketofol with the hassle?

Core EM: Propofol vs. Ketofol in PSA

EM: RAP: Just Enough Ketorlac

RebelEM: The Ketorolac Analgesic Ceiling

Core EM: Parenteral Ketorlac Dosing

Propofol or Ketofol for Procedural Sedation and Analgesia in Emergency Medicine-The POKER Study: A Randomized Double-Blind Clinical Trial. PubMed ID: 27460905

Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial. PubMed ID: 27993418