title: Propofol by infusion protocol for ED procedural sedation.
abstract: BACKGROUND
  Propofol is an effective agent for use in procedural sedation and analgesia (PSA). Most ED studies have used a bolus-dosed protocol. We evaluated the efficacy, complication rate, and satisfaction among caregivers and patients while using an infusion-dosed protocol of propofol for PSA in our ED.
  
  
  METHODS
  A prospective, observational study was performed in our academic ED. Propofol use was at the discretion of the ordering physician and dosed by predetermined infusion protocol. Variables measured included adverse events, times of sedation, procedure, and recovery. Patient and provider satisfaction were measured using a 10-cm visual analog scale.
  
  
  RESULTS
  Fifty patients were enrolled over 18 months. Procedures were varied, and all were successfully completed. The mean propofol dose was 174 mg (SD = 164 mg). Average times to sedation (4.6 minutes, SD = 2.6 minutes) and recovery (8.2 minutes, SD = 5.8 minutes) were short. Complications included 8 patients with respiratory depression and 6 with hypotension, all easily reversible. Satisfaction scores were uniformly high. Only 34% of patients had any memory of the procedure, and 94% would agree to use it again if necessary.
  
  
  CONCLUSIONS
  Infusion-dosed propofol is effective for ED PSA. Total doses, effectiveness, satisfaction rates, and complications of infusion-dosed propofol are comparable to findings from studies using bolus-dosed protocols.
authors.affiliation: Division of Emergency Medicine, University of Washington School of Medicine, Seattle, WA, USA. lfrank@u.washington.edu
authors.forename: Leonard R
authors.initials: LR
authors.lastname: Frank
authors.forename: Jared
authors.initials: J
authors.lastname: Strote
authors.forename: Samantha R
authors.initials: SR
authors.lastname: Hauff
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Bigelow
authors.forename: Kym
authors.initials: K
authors.lastname: Fay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D016292:Procedural Sedation / Q000295:instrumentation / Q000379:methods* / Q000592:standards*; D003702:Delusions / Q000139:chemically induced; D004305:Dose-Response Relationship, Drug; D004635:Emergency Medicine / Q000379:methods*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007022:Hypotension / Q000139:chemically induced; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000139:chemically induced
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol