Effect of propofol-based procedural sedation on risk of adverse events in a French emergency department: a retrospective analysis
| Autor: | Bertrand Guihard, Adrien Reuillard, Barbara Muller, Xavier Combes, Anne Marie Holman, Arnaud Michalon |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Sedation Conscious Sedation 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine medicine Humans Hypnotics and Sedatives Anesthesia Adverse effect Child Propofol Retrospective Studies business.industry Apnea 030208 emergency & critical care medicine Retrospective cohort study Emergency department Airway obstruction medicine.disease Confidence interval Emergency Medicine medicine.symptom business Emergency Service Hospital Anesthetics Intravenous medicine.drug |
| Zdroj: | European journal of emergency medicine : official journal of the European Society for Emergency Medicine. 27(6) |
| ISSN: | 1473-5695 |
| Popis: | OBJECTIVES Propofol is widely used today outside the operating room to facilitate painful procedures. The objective of this retrospective study was to evaluate the frequency and type of complications related to a propofol-based procedural sedation protocol used in a French emergency department. METHODS This retrospective study reviewed the records over a 6-year period of all patients-adults and children-who received propofol for procedural sedation according to a pre-established protocol. The frequency and type of adverse events related to this sedation were recorded. Adverse events were classified according to the World Society of Intra-Veinous Anaesthesia International Sedation Task Force as sentinel, moderate, minor, or minimal. RESULTS During the study period, 602 patients-395 adults (66%) and 207 (34%) children-received propofol. The main indications for procedural sedation were fracture (n = 327) and dislocation (n = 222) reduction, pleural drain placement (n = 34), and abscess incision (n = 12). Among the 602 consecutive cases, we identified 90 adverse events (14.9%; 95% confidence interval: 12-17.7%). These 90 events were classified as 1 sentinel (hypotension episode), 5 moderate (2 airway obstruction and 3 apnea episodes), 83 minor, and 1 minimal risk-averse events. There were no adverse outcomes. CONCLUSION Nearly all of the adverse events in our series were minor. In the French medical system, the use of propofol outside the operating room by non-anesthesiologist physicians for procedural sedation appears safe. |
| Databáze: | OpenAIRE |
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