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Propofol is an agent commonly used for procedural sedation and analgesia (PSA) in the emergency department (ED), but it can cause respiratory depression and hypotension. The combination of ketamine‐propofol (K‐P) is an alternative that theoretically provides a reduction in adverse events compared to propofol. The primary objective of this review was to determine if K‐P has a lower frequency of adverse respiratory events in patients undergoing PSA in the ED than propofol alone. Secondary objectives were to compare the proportion of overall adverse events, sedation time, procedure time, and recovery time between K‐P and propofol.

Electronic searches of Medline, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL were conducted and reference lists were hand‐searched. Randomized controlled trials (RCTs) published in English comparing the use of K‐P to …