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Propofol for procedural sedation in children in the emergency department

Kathlene E Bassett1, Jana L Anderson, Charles G Pribble

  • 1Division of Pediatric Emergency Medicine, Primary Children's Medical Center, University of Utah School of Medicine, Salt Lake City 84102, USA. kathlene.bassett@hsc.utah.edu

Annals of Emergency Medicine
|November 25, 2003
PubMed

Insights

Propofol sedation is safe and effective for painful emergency department procedures. While transient blood pressure drops and minor respiratory issues can occur, careful monitoring ensures patient safety.

Area of Science:

  • Emergency Medicine
  • Pediatric Sedation
  • Pharmacology

Background:

  • Painful procedures in the Emergency Department (ED) require effective sedation.
  • Propofol is an anesthetic agent with potential applications in procedural sedation.

Purpose of the Study:

  • To evaluate the safety and efficacy of propofol for painful procedures in a pediatric ED setting.
  • To establish a protocol for propofol administration in this context.

Main Methods:

  • A consecutive case series of 393 propofol sedations for painful procedures was analyzed.
  • A specific protocol involving propofol bolus and narcotic pre-administration was followed.
  • Data collected included adverse events, sedation duration, and recovery time.

Main Results:

  • Propofol was used for various procedures, predominantly fracture reductions (94%).
  • Transient hypotension occurred in 92% of patients, without signs of poor perfusion.
  • Hypoxia and minor airway interventions were observed in a small percentage of patients (5% and 3%, respectively), with no need for intubation.

Conclusions:

  • Propofol sedation, when guided by a protocol, is safe and efficacious for short, painful procedures in the ED.
  • Vigilant monitoring by skilled practitioners is crucial due to potential transient cardiopulmonary depression.
  • Propofol is a suitable option for procedural sedation in the emergency setting.
Abstract

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