Emergency Department Procedural Sedation with Propofol: Is it Safe?
Christopher S. Weaver, MD;* William E. Hauter, MD;* Edward J. Brizendine, MS; William H. Cordell, MD
Abstract
Propofol is a sedative agent gaining popularity for Emergency Department Procedural Sedation (EDPS). However, some institutions across the country continue to restrict the use of propofol secondary to safety concerns. The purpose of our study was to evaluate the complication rate of EDPS with propofol. We conducted a prospective, observational, multi-center study of EDPS patients aged 18 years, consenting to procedural sedation with propofol. Eighty-two patients from two Level I trauma centers were enrolled between August 1, 2002 and January 31, 2003. Transient hypoxemia was the only noted sedation complication. Nine patients (11%) had brief hypoxemia.
Propofol is a sedative agent gaining popularity for Emergency Department Procedural Sedation (EDPS). However, some institutions across the country continue to restrict the use of propofol secondary to safety concerns. The purpose of our study was to evaluate the complication rate of EDPS with propofol. We conducted a prospective, observational, multi-center study of EDPS patients aged 18 years, consenting to procedural sedation with propofol. Eighty-two patients from two Level I trauma centers were enrolled between August 1, 2002 and January 31, 2003. Transient hypoxemia was the only noted sedation complication. Nine patients (11%) had brief hypoxemia.
The combined average hypoxemia time was 1.2 min (SD 0.4), and in all instances responded to simple airway maneuvers or increased oxygen concentration. No patient required advanced airway maneuvers such as intubation or even positive pressure ventilation. EDPS with propofol seems to be safe in our population.
Introduction
In emergency medicine, sedatives or analgesics are frequently administered during brief, painful procedures (e.g., fracture or dislocation reduction, abscess incision and drainage, wound care, etc.). This is termed "emergency department procedural sedation" (EDPS) and various individual sedatives or a combination of sedatives may be utilized.
Propofol is a sedative agent that has recently become popular for EDPS. It has many characteristics that make it attractive for emergency department procedural sedation, including rapid induction of sedation and an extremely short half-life, leaving the patient with no residual sedation soon after the procedure is over.[35] Although the use of propofol during EDPS is increasing, some institutions across the country continue to restrict its usesecondary to safety concerns.
We conducted a prospective study to evaluate the complication rate of propofol during EDPS. In addition, we sought to investigate any possible predictors of those patients who might develop sedation events or complications when sedated with propofol.
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Introduction
In emergency medicine, sedatives or analgesics are frequently administered during brief, painful procedures (e.g., fracture or dislocation reduction, abscess incision and drainage, wound care, etc.). This is termed "emergency department procedural sedation" (EDPS) and various individual sedatives or a combination of sedatives may be utilized.
Propofol is a sedative agent that has recently become popular for EDPS. It has many characteristics that make it attractive for emergency department procedural sedation, including rapid induction of sedation and an extremely short half-life, leaving the patient with no residual sedation soon after the procedure is over.[35] Although the use of propofol during EDPS is increasing, some institutions across the country continue to restrict its usesecondary to safety concerns.
We conducted a prospective study to evaluate the complication rate of propofol during EDPS. In addition, we sought to investigate any possible predictors of those patients who might develop sedation events or complications when sedated with propofol.
DOWNLOAD PDF COMPLETE HERE
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