title: Propofol for sedation can shorten the duration of ED stay in joint reductions.
abstract: BACKGROUND
  For joint reductions, adequate sedation is often required. Propofol has increasingly been used for sedation in the emergency department (ED) in recent years. The benefits of propofol are the rapid onset of action and the short recovery time. However, whether these characteristics can shorten the duration of ED stay is not been proved.
  
  
  OBJECTIVE
  Our study retrospectively compared patients receiving propofol for sedation during joint reductions with those who received sedatives other than propofol. The primary objective was to compare the duration of ED stay between the 2 groups. The secondary outcomes were rate of adverse events and the success of the procedure.
  
  
  METHODS
  Patients were included if they had a dislocated joint requiring management in the ED. The following covariates were recorded on a standard form for each patient: age, sex, indication for procedural sedation, sedative used, pain medications used, physician levels, duration of ED stay, failed reduction, and adverse events. We further matched each patient in the propofol group to the patient in the nonpropofol group using a standard propensity score greedy-matching algorithm. The primary and secondary outcomes were compared accordingly.
  
  
  RESULTS
  A total of 241 patients met our inclusion criteria and were enrolled for further analysis. In the propensity score assignment, 56 patients (28 in each group) were further selected. The duration of ED stay in the propofol group is significantly shorter compared with the nonpropofol group (127 vs 192 minutes, P = .0019). The successful reduction rate is higher in the propofol group (96.4% vs 64.3%, P = .002). The complication rate is similar in both groups (3.6% vs 0%, P = .313).
  
  
  CONCLUSIONS
  Propofol is a safe sedative with few complications and higher successful rates when applied in the joint reductions. It can also shorten the duration of ED stay.
authors.affiliation: Emergency Department, Buddhist Tzu Chi Dalin General Hospital, Chiayi County 622, Taiwan (R.O.C.).
authors.forename: Yi-Kung
authors.initials: YK
authors.lastname: Lee
authors.forename: Chien-Chih
authors.initials: CC
authors.lastname: Chen
authors.forename: Hsin-Yi
authors.initials: HY
authors.lastname: Lin
authors.forename: Chen-Yang
authors.initials: CY
authors.lastname: Hsu
authors.forename: Yung-Cheng
authors.initials: YC
authors.lastname: Su
mesh_terms: D000328:Adult; D016292:Procedural Sedation / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D004204:Joint Dislocations; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D059408:Pain Management / Q000379:methods; D057216:Propensity Score; D015742:Propofol; D012189:Retrospective Studies
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol