How a backwards way of using Ketamine plus Propofol aka ketofol turned out on this patient. In this case we used Profofol without adequate sedation, then Ketamine was given. Howling turned out to be the ongoing emergence phenomenon for this patient I believe. instead of giving the classical sedative of midazolam afterwards. I already had propfol with me, so I have it instead. The howling stopped. The patient didnt even know the painful procedure of draining of a perianal abscess was already completed.