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New research · Anesthesiology
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 23h
Randomized trialJournal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026

Effect of ketofol versus Fentanyl-Midazolam sedation on neurological recovery in traumatic brain Injury: A randomised study.

Umadevi Manyam, Navdeep Sokhal, Suman Sokhal … Vinay Chitturi
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AnesthesiologyRandomized trial

Ketofol sedation is associated with higher odds of good neurological recovery at 30 days.

Effect of ketofol versus Fentanyl-Midazolam sedation on neurological recovery in traumatic brain Injury: A randomised study.

Umadevi Manyam et al. · Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
Background

Neurological recovery after traumatic brain injury (TBI) is multifactorial, and sedation is a cornerstone of neurocritical care because of its neuroprotective role.

Methods

This preliminary exploratory double-blind, randomised study compared ketofol (KP) with fentanyl-midazolam (FM) sedation in adults with moderate-to-severe TBI.

Results

ketofol sedation is linked to much higher chances of good brain recovery after 30 days

OR 3.63 (95% CI 1.11 to 11.85)
null = 11.1111.85
CI excludes the null - significant
More results

Although ketofol is widely used for anaesthesia, its effectiveness as a sedative regimen in the intensive care unit (ICU) has not been well studied.

The primary outcome was the Extended Glasgow Outcome Scale (GOSE) at 30 days.

More results

Secondary outcomes included GOSE at 90 days, incidence of propofol infusion syndrome (PRIS), duration of mechanical ventilation, haemodynamic stability, and ICU and hospital length of stay.

Baseline characteristics, including injury severity and Marshall CT scores, were comparable.

“
Conclusion

Ketofol-based sedation was safe and may be associated with improved early neurological recovery compared with fentanyl-midazolam, with a favourable trend toward improved long-term neurological recovery.

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