title: Patient satisfaction with procedural sedation in the emergency department.
abstract: OBJECTIVE
  The aim of this study was to determine patient satisfaction with procedural sedation as a function of nature of the procedure and depth of sedation.
  
  
  METHODS
  We undertook a prospective observational study of adult patients who received procedural sedation in two EDs (20 month period). The level of sedation was determined by an investigator, using the Observers Assessment of Anaesthesia/Sedation Scale (1 = awake to 6 = no response to noxious stimuli). Patient satisfaction was measured with the Iowa Satisfaction with Anaesthesia Scale after full recovery. This was self-administered, comprised 11 items (e.g. 'I felt pain') and has a score range of -3 (poor satisfaction) to +3 (very satisfied).
  
  
  RESULTS
  A total of 163 patients were enrolled (51.2% men, mean age 50.7 years). The median (interquartile range) satisfaction score was 2.7 (0.7). Patient satisfaction was lower among patients who had orthopaedic procedures (median 2.6 vs 2.8, P < 0.01) and among patients who had a pre-sedation opioid (2.6 vs 2.8, P = 0.03). Satisfaction was positively correlated with deeper sedation (Spearman's correlation coefficient 0.49, P < 0.001). Satisfaction also differed significantly between the four most common sedation regimens (P < 0.001). It was greatest among those who were administered propofol with or without fentanyl and least among those who were administered nitrous oxide with or without opioid. Patients sedated with propofol with or without fentanyl had the greatest depths of sedation. There was no difference in satisfaction among patients who were and were not sedated by a consultant (median 2.6 and 2.7, respectively, P = 0.84).
  
  
  CONCLUSIONS
  Generally, the level of patient satisfaction is high. Greater satisfaction is associated with deeper sedation, sedation with propofol and non-orthopaedic procedures.
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Olivia G
authors.initials: OG
authors.lastname: Johnson
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.|Emergency Department, Austin Hospital, Melbourne, Victoria, Australia.
authors.forename: David McD
authors.identifier: http://orcid.org/0000-0002-8986-9997
authors.initials: DM
authors.lastname: Taylor
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Marina
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Juen-Li
authors.initials: JL
authors.lastname: Ding
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Aadith
authors.initials: A
authors.lastname: Ashok
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Damian
authors.initials: D
authors.lastname: Johnson
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Peck
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.|Emergency Department, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Knott
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Anaesthesia, Austin Hospital, Melbourne, Victoria, Australia.
authors.forename: Laurence
authors.initials: L
authors.lastname: Weinberg
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000494:pharmacology / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000494:pharmacology / Q000627:therapeutic use; D016292:Procedural Sedation / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D005283:Fentanyl / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009609:Nitrous Oxide / Q000494:pharmacology / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy; D017060:Patient Satisfaction; D015742:Propofol / Q000494:pharmacology / Q000627:therapeutic use; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D009609:Nitrous Oxide; D005283:Fentanyl; D015742:Propofol
keywords: conscious sedation; emergency department; patient experience; patient satisfaction; procedural sedation