The safety of deep sedation without intubation for abortion in the outpatient setting

Study Objective: To determine the rate of perioperative pulmonary aspiration in patients undergoing first and second-trimester surgical abortion during deep sedation with propofol, without intubation. Design: Retrospective review of cases of surgical and anesthetic complications reported to the Office of Quality Management of the surgical facility between August 1, 2001 and April 30, 2008. Setting: Large urban surgical abortion outpatient facility. Measurements: The medical records of all surgical abortion patients who underwent hospital transfer were reviewed. From billing records, all patients who underwent abortion during deep sedation were identified. The primary outcome was the rate of perioperative pulmonary aspiration. Secondary outcomes included the rates of other anesthesia-related adverse events resulting in hospital transfer. Main Results: During the 81-month study period, the facility performed 62,125 surgical abortions during deep sedation, including 11,039 second-trimester abortions. Only one patient received endotracheal intubation. No cases of perioperative pulmonary aspiration occurred. Conclusions: Deep sedation without intubation is a viable method of anesthesia for both first and second-trimester surgical abortions in the outpatient setting. (C) 2011 Elsevier Inc. All rights reserved.