Effect of ketofol versus Fentanyl-Midazolam sedation on neurological recovery in traumatic brain Injury: A randomised study.
J Clin NeurosciJul 22, 2026 (epub)
Umadevi Manyam, Navdeep Sokhal, Suman Sokhal et al.
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In 30 seconds
This randomized controlled trial evaluated the effects of ketofol versus fentanyl-midazolam sedation on neurological recovery in adults with moderate-to-severe traumatic brain injury (TBI). Among 111 patients analyzed, good neurological recovery at 30 days was significantly higher in the ketofol group (26% vs. 10.5%, p = 0.03).
Key findings
- At 30 days, good neurological recovery (GOSE 7-8) was 26% in the ketofol group compared to 10.5% in the fentanyl-midazolam group (p = 0.03).
- At 90 days, recovery rates were 44.4% for ketofol and 33.3% for fentanyl-midazolam, but not statistically significant (p = 0.16).
- Multivariate analysis indicated ketofol as an independent predictor of good recovery at 30 days (adjusted OR 3.63, 95% CI 1.11-11.85, p = 0.033).
Why it matters
The choice of sedation in neurocritical care can influence neurological outcomes in TBI patients. This study suggests that ketofol may enhance early recovery, which is crucial for patient prognosis and rehabilitation.