{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:30:43Z","timestamp":1787772643325,"version":"build-2784847793"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Ketamine has been a safe and effective sedative agent commonly used for painful pediatric procedures in the emergency department (ED). This study aimed to compare the effect of dexmedetomidine (Dex) and propofol when used as co-administration with ketamine on recovery agitation in children who underwent procedural sedation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>In this prospective, randomized, and double-blind clinical trial, 93 children aged between 3 and 17 years with American Society of Anesthesiologists Class I and II undergoing short procedures in the ED were enrolled and assigned into three equal groups to receive either ketadex (Dex 0.7 \u03bcg\/kg and ketamine 1 mg\/kg), ketofol (propofol 0.5 mg\/kg and ketamine 0.5 mg\/kg), or ketamine alone (ketamine1 mg\/kg) intravenously. Incidence and severity of recovery agitation were evaluated using the Richmond Agitation-Sedation Scale and compared between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There was no statistically significant difference between the three groups with respect to age, gender, and weight (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). The incidence of recovery agitation was 3.2% in the ketadex group, 22.6% in the ketofol group, and 22.6% in the ketamine group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002, children undergoing short procedures were recruited). There was a less unpleasant recovery reaction (hallucination, crying, and nightmares) in the ketadex group compared with the ketofol and ketamine groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). There was no difference in the incidence of oxygen desaturation between the groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.30).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The co-administering of Dex to ketamine could significantly reduce the incidence and severity of recovery agitation in children sedated in the ED.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jrms.jrms_661_20","type":"journal-article","created":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T08:27:23Z","timestamp":1630312043000},"page":"61","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Comparison of the effects of dexmedetomidine and propofol in reducing recovery agitation in pediatric patients after ketamine procedural sedation in emergency department"],"prefix":"10.4103","volume":"26","author":[{"given":"Reza","family":"Azizkhani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soheila","family":"Kouhestani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhad","family":"Heydari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrdad","family":"Esmailian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awat","family":"Feizi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahar","family":"Khalilian Gourtani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadreza","family":"Safavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-61-20240830","first-page":"91","article-title":"Procedural sedation and analgesia in children","volume":"371","author":"Krauss","year":"2014","journal-title":"N Engl J Med"},{"key":"R2-61-20240830","doi-asserted-by":"crossref","first-page":"19","DOI":"10.4103\/abr.abr_143_16","article-title":"Ketamine versus ketamine\/magnesium sulfate for procedural sedation and analgesia in the emergency department: A randomized clinical trial","volume":"7","author":"Azizkhani","year":"2018","journal-title":"Adv Biomed Res"},{"key":"R3-61-20240830","doi-asserted-by":"crossref","first-page":"860","DOI":"10.4103\/1735-1995.170607","article-title":"Ketamine administration makes patients and physicians satisfied during gastro-enteric endoscopies","volume":"20","author":"Majidinejad","year":"2015","journal-title":"J Res Med Sci"},{"key":"R4-61-20240830","doi-asserted-by":"crossref","first-page":"89","DOI":"10.4103\/2279-042X.155758","article-title":"Midazolam premedication for Ketamine-induced emergence phenomenon: A prospective observational study","volume":"4","author":"Perumal","year":"2015","journal-title":"J Res Pharm Pract"},{"key":"R5-61-20240830","first-page":"7511","article-title":"Effect of ondansetron on the incidence of ketamine associated vomiting in procedural sedation and analgesia in children: A double-blind, randomized, placebo-controlled trial","volume":"6","author":"MajidiNejad","year":"2018","journal-title":"Int J Pediatr"},{"key":"R6-61-20240830","doi-asserted-by":"crossref","first-page":"256","DOI":"10.12816\/0003231","article-title":"Does haloperidol prophylaxis reduce ketamine-induced emergence delirium in children?","volume":"13","author":"Amr","year":"2013","journal-title":"Sultan Qaboos Univ Med J"},{"key":"R7-61-20240830","doi-asserted-by":"crossref","first-page":"219","DOI":"10.4274\/eajem.galenos.2020.67689","article-title":"The effect of low dose ketamine on the need for morphine in patients with multiple trauma in emergency department","volume":"19","author":"Heydari","year":"2020","journal-title":"Eurasian J Emerg Med"},{"key":"R8-61-20240830","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/S0196-0644(00)70073-4","article-title":"Does adjunctive midazolam reduce recovery agitation after ketamine sedation for pediatric procedures. 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