Ketamine versus propofol for procedural sedation in pediatric pulsed dye laser therapy: a prospective randomized trial
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By
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Marija Stevic
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Nina Ristic
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Ivana Budic
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Branislav Trifunovic
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Vesna Marjanovic
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Suzana Bojic
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Dejan Zivorad Marković
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Marija Jovanovski Srceva
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Dragan Nenadic
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Ana Vlajkovic Ivanovic
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Lazar Milic
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Dejan Nikolic
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April 30, 2026
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Clinical Scorecard: Comparison of Ketamine and Propofol for Sedation During Pediatric Pulsed Dye Laser Treatment: A Prospective Randomized Study
At a Glance
| Category | Detail |
|---|
| Condition | Port-wine stains (PWS) |
| Key Mechanisms | Analgosedation using propofol or ketamine |
| Target Population | Children aged 1–18 years (ASA I–II) |
| Care Setting | Outpatient procedures |
Key Highlights
- Respiratory depression was significantly higher in the propofol group (19.5%) compared to the ketamine group (2.6%).
- Ketamine was associated with higher rates of hypertension, tachycardia, and psychomimetic effects.
- Propofol led to more hypotension and longer recovery times compared to ketamine.
- Sedation depth was comparable between both agents.
- Procedural duration ≥13.5 min predicted respiratory depression in the propofol group.
Guideline-Based Recommendations
Diagnosis
- Assess the need for analgosedation in pediatric patients undergoing PDL therapy.
Management
- Consider ketamine for better respiratory stability, especially in longer procedures.
Monitoring & Follow-up
- Standardized monitoring including ECG, blood pressure, pulse oximetry, and end-tidal CO₂ is essential.
Risks
- Be aware of the higher risk of respiratory depression with propofol and other adverse effects with ketamine.
Patient & Prescribing Data
Children aged 1–18 years undergoing PDL therapy for PWS.
Individualize anesthetic selection based on procedural duration and patient risk factors.
Clinical Best Practices
- Utilize standardized monitoring during sedation.
- Evaluate the patient's ASA status before selecting sedative agents.
- Educate caregivers about potential side effects of both propofol and ketamine.
References
