Ketamine Versus Fentanyl as an Adjunct to Propofol-Assisted Emergency Department Procedural Sedation

Inclusion Criteria: Individuals presenting or referred to the Emergency Department at Kingston General Hospital with a fracture or dislocation requiring manipulation under procedural sedation; or abscess requiring incision and drainage under procedural sedation. Ability to provide informed consent according to institutional requirements. Ability to comprehend and communicate in English. Exclusion Criteria: Age < 14 or > 65 years Any history of significant active cardiac, pulmonary, hepatic or renal disease, as determined by patient history, chart review, or emergency physician. American Society of Anesthesiology (ASA) classification greater than class II. Body mass > 130 kg. A history of physician-diagnosed obstructive sleep apnea. Chronic use of opioids including methadone and buprenorphine. A self-reported history of recent substance abuse or prior opioid dependence. Acute intoxication with drugs or alcohol, based on the judgement of the attending physician. A history of psychotic disorders, as reported by subjects or identified on review of the medical records. A known history of allergy or sensitivity to any study medication.