title: Emergency Procedural Sedation With Propofol in Older Teenagers: Any Cause for Concern?
abstract: BACKGROUND
  Propofol is a standard for adult emergency department procedural sedation (EDPS). Use in pediatric patients remains controversial. Our primary objective was to investigate whether adverse events occurred more frequently in teenage pediatric patients receiving propofol for EDPS.
  
  
  METHODS
  This retrospective study examines records from the Halifax Procedural Sedation Registry, collected between January 1, 2006 and May 31, 2013. Patients undergoing EDPS using propofol were divided into those aged 16 to 19 years (teenagers), 20 to 65 years (adults), and older than 65 years (seniors). The primary outcomes were the incidences of hypotension and hypoxia.
  
  
  RESULTS
  Four thousand sixty-three EDPSs were included in the analysis, of which 230 involved teenagers, 2853 adults (mean age, 43.0 years), and 980 seniors (mean age, 77.1). The teenage group was significantly less likely to develop hypotension or hypoxia. These differences were confirmed on multivariate analysis. Patients in the teenage group received higher doses of propofol per kilogram/minute than the other groups. No other differences met statistical significance.
  
  
  CONCLUSIONS
  Teenage patients receiving EDPS with propofol had a lower incidence of adverse events, and both received and tolerated larger adjusted doses of medication than older patients. Satisfaction and duration of EDPS were similar. Concerns about propofol use in younger patients have not been supported by this study. We believe that these findings support the use of propofol for EDPS in older teenagers.
authors.affiliation: From the Department of Emergency Medicine, Dalhousie University Halifax, Halifax, Nova Scotia, Canada.
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Campbell
authors.forename: Shannon
authors.initials: S
authors.lastname: MacPhee
authors.forename: Michael
authors.initials: M
authors.lastname: Butler
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Zed
authors.forename: Patrick
authors.initials: P
authors.lastname: Froese
authors.forename: Mary-Lynn
authors.initials: ML
authors.lastname: Watson
authors.forename: Robert
authors.initials: R
authors.lastname: MacKinley
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D054810:Deep Sedation; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000009:adverse effects*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol