ArticleCureus2026
A Prospective Comparative Non-randomized Study of Ketofol Versus Midazolam Sedation in Flexible Bronchoscopy.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Flexible bronchoscopy requires reliable sedation that preserves respiratory drive while ensuring patient comfort and procedural efficiency. Midazolam, a benzodiazepine, is widely employed but is associated with respiratory depression, unpredictable recovery kinetics, and compromised oxygenation, particularly in patients with underlying pulmonary disease. Ketofol, a fixed-ratio admixture of ketamine and propofol, exploits the pharmacodynamic complementarity of its constituents: ketamine maintains airway reflexes and sympathetic tone, while propofol confers rapid-onset sedation and swift recovery. Head-to-head comparative evidence for ketofol versus midazolam in flexible bronchoscopy remains limited. Methods This prospective comparative non-randomized study enrolled 80 adult patients scheduled for flexible bronchoscopy at the Department of Respiratory Medicine, Santiniketan Medical College Hospital. Allocation to the ketofol group (n = 40) or the midazolam group (n = 40) was determined by the treating bronchoscopist in consultation with the attending anesthesiologist before the procedure, based on clinical judgment, anticipated airway tolerance, procedural requirements, comorbidity profile, and operator familiarity with the sedative regimen. A standardized pre-procedure assessment form was used, and the sedation choice was documented before bronchoscope insertion. Because of the observational nature of the study, no randomization, allocation concealment, or blinding was employed. Continuous monitoring included pulse oximetry, non-invasive blood pressure, and electrocardiography. Primary endpoints were the incidence of intraoperative cough events and desaturation episodes (SpO
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