Propofol by infusion protocol for ED procedural sedation

被引:24
作者
Frank, Leonard R.
Strote, Jared
Hauff, Samantha R.
Bigelow, Suzanne K.
Fay, Kym
机构
[1] Univ Washington, Med Ctr, Dept Emergency Med, Sch Med, Seattle, WA 98195 USA
[2] Univ Michigan, Sch Med, Dept Emergency Med, Ann Arbor, MI 48109 USA
[3] Boston Univ, Sch Med, Dept Emergency Med, Boston, MA 02215 USA
关键词
D O I
10.1016/j.ajem.2006.02.008
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: Propofol is an effective agent for use in procedural sedation and analgesia (PSA). Most ED studies have used a bolus-dosed protocol. We evaluated the efficacy, complication rate, and satisfaction among caregivers and patients while using an infusion-dosed protocol of propofol for PSA in our ED. Methods: A prospective, observational study was performed in our academic ED. Propofol use was at the discretion of the ordering physician and dosed by predetermined infusion protocol. Variables measured included adverse events, times of sedation, procedure, and recovery. Patient and provider satisfaction were measured using a 10-cm visual analog scale. Results: Fifty patients were enrolled over 18 months. Procedures were varied, and all were successfully completed. The mean propofol dose was 174 mg (SD = 164 mg). Average times to sedation (4.6 minutes, SD = 2.6 minutes) and recovery (8.2 minutes, SD = 5.8 minutes) were short. Complications included 8 patients with respiratory depression and 6 with hypotension, all easily reversible. Satisfaction scores were uniformly high. Only 34% of patients had any memory of the procedure, and 94% would agree to use it again if necessary. Conclusions: Infusion-dosed propofol is effective for ED PSA. Total doses, effectiveness, satisfaction rates, and complications of infusion-dosed propofol are comparable to findings from studies using bolus-dosed protocols. (c) 2006 Elsevier Inc. All rights reserved.
引用
收藏
页码:599 / 602
页数:4
相关论文
共 16 条
[1]   Propofol for procedural sedation in children in the emergency department [J].
Bassett, KE ;
Anderson, JL ;
Pribble, CG ;
Guenther, E .
ANNALS OF EMERGENCY MEDICINE, 2003, 42 (06) :773-782
[2]   Pharmacology of emergency department pain management and conscious sedation [J].
Blackburn, P ;
Vissers, R .
EMERGENCY MEDICINE CLINICS OF NORTH AMERICA, 2000, 18 (04) :803-+
[3]   Propofol for emergency department procedural sedation and analgesia: A tale of three centers [J].
Burton, JH ;
Miner, JR ;
Shipley, ER ;
Strout, TD ;
Becker, C ;
Thode, HC .
ACADEMIC EMERGENCY MEDICINE, 2006, 13 (01) :24-30
[4]   Propofol infusion for induction and maintenance of anesthesia in elderly patients: Recovery and hemodynamic profiles [J].
Chan, VWS ;
Chung, FF .
JOURNAL OF CLINICAL ANESTHESIA, 1996, 8 (04) :317-323
[5]   Sedation for cardioversion in the emergency department:: Analysis of effectiveness in four protocols [J].
Coll-Vinent, B ;
Sala, X ;
Fernández, C ;
Bragulat, E ;
Espinosa, G ;
Miró, O ;
Millá, J ;
Sánchez, M .
ANNALS OF EMERGENCY MEDICINE, 2003, 42 (06) :767-772
[6]   Propofol for deep procedural sedation in the ED [J].
Frazee, BW ;
Park, RS ;
Lowery, D ;
Baire, M .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 2005, 23 (02) :190-195
[7]   Propofol in emergency medicine: Pushing the sedation frontier [J].
Green, SM ;
Krauss, B .
ANNALS OF EMERGENCY MEDICINE, 2003, 42 (06) :792-797
[8]   Propofol sedation by emergency physicians for elective pediatric outpatient procedures [J].
Guenther, E ;
Pribble, CG ;
Junkins, EP ;
Kadish, HA ;
Bassett, KE ;
Nelson, DS .
ANNALS OF EMERGENCY MEDICINE, 2003, 42 (06) :783-791
[9]  
GUENTHERSKOKAN E, 2001, CLIN PEDIATR, V40, P663
[10]  
McFarlan CS, 1999, PAEDIATR ANAESTH, V9, P209