Midazolam or propofol added to ketamine: Which combination is better for the reduction of shoulder dislocation in the emergency department?
Turkish Journal of Emergency Medicine January 1, 2026 Mert Pehlivan, Selen Acehan, Salim Satar et al.
For anterior shoulder dislocations treated in the emergency department, the combination of ketamine and propofol (KP) provided deeper sedation, shorter procedure and recovery times, and fewer adverse events than the combination of ketamine and midazolam (KM). The average Ramsay sedation score was higher with KP, and procedure time averaged 5.7 minutes and recovery time 36.3 minutes, both significantly shorter in the KP group. Adverse events such as respiratory depression and tachycardia were more common in the KM group. The ketamine-propofol combination appears to be a safe and effective option for procedural sedation during shoulder reduction.