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tom f. -

excellent!!! I have heard varied comments regarding ketofol. like they either love it or hate it. I suspect most use the one syringe with the 0.5 mg /kg of each (or 1/kg). but I LOVE Sean's way of two syringes, front load with ketamine 1-2mg/kg, then titrate your propofol. ketamine alone I found useless for reductions (no muscle relaxation, and sometimes spasm and muscle tightening it seems. enough propofol can turn the muscles into butter, and an easy reduction. what we discussed in Weingart's RLA also is pre-oxygenate with 100% face mask for a few minutes while setting up. this gives a few extra minutes of maintained oxygenation I think if there is transient apnea from the propofol.
love this pod. thank you Sean and Jessie.

tom fiero
merced, cali

Sean N. -

Hi Tom,

Thank you for the comments and including your experience with ketamine and propofol!

Medicine, as we all know, is an art and much of that art is painted with medications as the brushes being used in different ways by different “artists”

What we discuss is one suggested approach to ketofol and I am sure others have great but different ways they use ketofol

As Jessie and I discussed, I find the two syringe method to be clinically more favorable than the single syringe method

Agree entirely with you and Scott about preoxygenating with 100% oxygen by face mask as set up

Good preparation and anticipating adverse events goes a long way

Thanks for what you do!


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CorePendium Spotlight: Ketofol Full episode audio for MD edition 16:07 min - 18 MB - M4A