Propofol by infusion protocol for ED procedural sedation.
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.
Frank
Leonard R
LR
Division of Emergency Medicine, University of Washington School of Medicine, Seattle, WA, USA. lfrank@u.washington.edu
Strote
Jared
J
Hauff
Samantha R
SR
Bigelow
Suzanne K
SK
Fay
Kym
K
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
D006993:Hypnotics and Sedatives; D015742:Propofol