Ketadex Versus Ketofol for Adult Procedural Sedation in the Emergency Department.

This randomized controlled trial will compare two medication combinations, ketamine-dexmedetomidine (Ketadex) and ketamine-propofol (Ketofol), for procedural sedation in adults undergoing painful procedures in the emergency department. The primary objective is to compare the respiratory safety of the two sedation regimens, particularly the occurrence of hypoxic events and the need for airway interventions. Participants will be randomly assigned to receive either Ketadex or Ketofol. The study will also compare recovery time, hemodynamic effects, pain, emergence reactions, nausea and vomiting, and other adverse events between the two groups. The study will be conducted in the Emergency Department at Sultan Qaboos University Hospital, University Medical City, Oman.

Inclusion Criteria: * Age ≥18 years. * Requiring procedural sedation for a diagnostic or therapeutic procedure in the Emergency Department. * ASA class I-II, or stable ASA class III at the treating physician's discretion. * Procedure anticipated to last \