Delving into the Latest Updates on Propofol/Ketamine Hydrochloride with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

Ketofol

Target

GABAA receptor x NMDA receptor

Action

agonists

Mechanism

GABAA receptor agonists(Gamma-aminobutyric acid A receptor agonists), NMDA receptor agonists(Glutamate [NMDA] receptor agonists)

Therapeutic Areas-

Active Indication-

Inactive Indication-

Originator Organization-

Active Organization-

Inactive Organization-

Drug Highest PhaseApproved

First Approval Date-

Regulation-

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Structure/Sequence

Molecular FormulaC12H18O

InChIKeyOLBCVFGFOZPWHH-UHFFFAOYSA-N

CAS Registry2078-54-8

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BACKGROUNDA rapid and smooth emergence is essential in patients undergoing trans-sphenoidal pituitary surgeries. Ketofol has been used as an anesthetic agent with good recovery characteristics. We conducted this study to compare the recovery profile of the patients receiving propofol-dexmedetomidine or ketofol-dexmedetomidine infusions for trans-sphenoidal excision of pituitary tumours.MATERIALS AND METHODSForty adult patients undergoing endoscopic pituitary surgery received either an infusion of propofol (Group P) or ketofol, 1:5 (Group KP)at 0.6-0.9ml/kg/h. Dexmedetomidine (0.5 μg/kg/ h) was administered in both groups. Our aim was to assess the recovery time, extubation time, emergence time. We also assessed the intraoperative hemodynamics, cerebral oxygenation, quality of the surgical field and postoperative pain.RESULTSThe recovery time (Group KP v/s P; 16.5 ± 4.3 v/s 8.3 ± 2.7 mins, P <0.01), emergence time (12.9 ± 3.9 v/s 5.7 ± 2.7 mins, P<0.01) and extubation time (14.3 ± 4.2 v/s 7.2 ± 2.8 mins, P <0.01) was longer in Group KP as compared to Group P. However, the patients in Group KP had lower cough scores, and pain scores, along with better maintenance of hemodynamic stability and cerebral oxygenation. The agitation score, cognition score, and quality of the surgical field were comparable.CONCLUSIONThe use of ketofol resulted in a longer recovery time compared to the use of propofol alone. However, ketofol was associated with a better quality of extubation, maintenance of hemodynamic stability, and enhanced postoperative analgesia. Further research is needed to conclusively establish its efficacy and optimal dosage in pituitary surgery.

01 Oct 2024·Saudi Journal of Anaesthesia

Comparison of effects of dexmedetomidine with ketofol and ketofol alone on quality of sedation in pediatric patients undergoing magnetic resonance imaging: A prospective randomized controlled double-blind trial

Article

Author: Kumar, Rakesh ; Bhatia, Pradeep ; Chakravarty, Reena ; Kamal, Manoj ; Goyal, Neha ; Mohammed, Sadik ; Chhabra, Swati

Background and Aim:Patient movement during magnetic resonance imaging (MRI) is the most frequent cause of artifacts and poor scan quality. Children cannot lie still. Thus, anesthesia is required to keep the child calm and immobile. This randomized double-blinded clinical trial compares the clinical effects of the addition of dexmedetomidine as premedication with ketofol on the quality of sedation. We hypothesized that the addition of dexmedetomidine would improve the quality of sedation.Methods:A total of 132 children aged 6 months to 10 years were randomized into groups DK (dexmedetomidine–ketofol) and K (ketofol). DK received an intravenous bolus of dexmedetomidine (0.5 mcg/kg) as premedication 10 minutes prior. Both the groups were induced with ketofol (0.5 mg/kg), and sedation was maintained with propfol infusion (100 mcg/kg/min). The primary objective was the quality of sedation as assessed by the University of Michigan Sedation Scale. Image quality, requirement of rescue propofol dose, recovery, and adverse events were also studied. Data are given as median [interquartile range (IQR)] or frequency.Results:All 132 children completed MRI scans. The DK group showed significantly better quality of sedation, 71% versus 47% of children, a median difference of 1 (-0.569 to -0.0969), P < .005, a better quality of scan, a reduced number of additional doses of propofol, and a decreased total dose of propofol. Hemodynamic parameters and recovery times for the two groups were similar. There were no significant side effects in both groups.Conclusion:The quality of sedation and the quality of the MRI scan are greatly improved by administering dexmedetomidine (0.5 mcg/kg) 10 minutes before to induction. Additionally, this technique decreases the need of propofol and gives better hemodynamic stability without delaying the recovery time.

01 Oct 2024·Pediatric Anesthesia

Pilot data comparing ketofol total intravenous anesthesia versus inhalational anesthesia for flexible scope‐guided nasal intubation in children

Article

Author: Bhardwaj, Neerja ; Menon, Prema ; Yaddanapudi, Sandhya ; Mathew, Preethy J. ; Gupta, Aakriti ; Rimal, Ankit

100 Deals associated with Propofol/Ketamine Hydrochloride

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R&D Status

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT02863861 (Pubmed \| Rev Bras Anestesiol)	Phase 4	Sedation	120	Propofol-Ketamine	glvwsythkh(uxvzphwqzk) = bnvmauqfsl dknenwzsuy (pvvrssujcd ) View more	-	01 Nov 2020
				Dexmedetomidine-Ketamine	glvwsythkh(uxvzphwqzk) = psknslnhmp dknenwzsuy (pvvrssujcd ) View more
NCT02643979 (CTgov)	Phase 4	Sleep Apnea Syndromes \| Obesity	22	Propofol+Saline (Propofol Only)	ibqevazwvj(zovvadulle) = bjdaxielsi ooktgqxcue (vayoleuuud, fxnascmids - fbmfppnwtk) View more	-	28 Jan 2020
				ketofol+Propofol (Ketofol and Propofol)	duowgzwntz(kieuavtczr) = urxvgdfamh mknfiyvgfy (ezvzadbrra, wexougappf - hrhgwuzmbh) View more
NCT02105415 (KEEP PACE, CTgov)	Phase 2/3	Critical Illness	160	Etomidate (Etomidate)	ukscuvewpq(shuveutgxj) = lpshohnjgy hymiutwzvs (baswvarddh, biehsddzoc - sapupuaurc) View more	-	11 Jan 2019
				Ketamine / Propofol Admixture (Ketamine / Propofol Admixture)	ukscuvewpq(shuveutgxj) = zzafffrpbk hymiutwzvs (baswvarddh, meepvhmcuc - kqvsefdcup) View more
NCT02848963 (Pubmed \| J Anesth)	Phase 4	-	75	1:5 ketofol mixture	xsyrvcolfh(ukjytmckqi) = vrvhsyydgt sraxdharem (lgfbjzrylz, 308.1 - 434.48) View more	-	01 Feb 2018
				1:6.7 ketofol mixture	xsyrvcolfh(ukjytmckqi) = uluybdwytj sraxdharem (lgfbjzrylz, 292.2 - 394.3) View more
ACTRN12610001056088 (POKER Study, Pubmed \| Ann Emerg Med)	Not Applicable	Sedation \| Analgesia	-	Ketofol	(ltkikipvay) = mrvppkdwiu bnqfuqzxre (kwnruelqpj ) View more	-	01 Nov 2016
				Propofol	(ltkikipvay) = hvzcxixuhi bnqfuqzxre (kwnruelqpj ) View more
NCT01260662 (CTgov)	Phase 4	Sedation	271	Propofol (Propofol)	nzckjuhvfq(cbzwqgzwzf) = tsuqursuvj avsfuorpfl (rnquzzqvtp, zlfvtsximh - fdisvvlizo) View more	-	29 Apr 2015
				1:1 Propofol/Ketamine (1:1 Propofol/Ketamine)	nzckjuhvfq(cbzwqgzwzf) = pcbeshltxs avsfuorpfl (rnquzzqvtp, hemcncqihs - xjdaaagskf) View more
NCT01211158 (Pubmed \| Ann Emerg Med)	Phase 3	Sedation	284	Ketofol	aorheskusu(myghsinnsv) = 4 patients (3.5%; 95% CI 1.0% to 8.7%) required adjunctive medication for sedation nfgfbdplfx (tdmddsdstd ) View more	Positive	01 Jan 2007