Propofol infusion platforms: opportunities and challenges.
Several propofol infusion platforms have been devised to address the inherent safety problems associated with propofol administration. Patient-controlled and target-controlled infusion systems have been described in the literature, and the Sedasys closed-loop feedback system is in FDA review. No matter what the infusion platform, there are important safety concerns that should be addressed whenever propofol is administered by non-anesthesiologists. There must be safeguards in the facility's sedation protocol for non-anesthesiologists that involve training, documentation, auditing/oversight, quality improvement and involvement of the facility's pharmacy and therapeutics committee. Definitions of levels of sedation and recommendations from the American Society of Anesthesiologists on rescue, identification and management of potential complications, as well as monitoring and training of personnel are also presented.
Maurer
Walter G
WG
Ambulatory Anesthesia, Anesthesia Institute, Cleveland Clinic, Cleveland, Ohio, USA. MAURERW@ccf.org
Philip
Beverly K
BK
D000776:Anesthesiology / Q000193:education / Q000592:standards; D016292:Procedural Sedation / Q000379:methods*; D004282:Documentation; D006282:Health Personnel / Q000193:education; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007262:Infusions, Intravenous / Q000379:methods; D008485:Medical Audit; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D011785:Quality Assurance, Health Care
D006993:Hypnotics and Sedatives; D015742:Propofol