Propofol for Procedural Sedation in Adults

Author: Gavin Lloyd / Editor: Jonathan M Jones, William Gibbs / Reviewer: Joe Schrieber / Codes: / Published: 16/08/2018 / Reviewed: 26/07/2024

This module covers indications for Propofol sedation, identifying suitable patients and those at higher risk of adverse events, a standardised procedure for Propofol sedation (protocol), strategies for addressing adverse events and all relevant governance issues.

After completing this session you will be able to:

  • Understand the principles of safe sedation with propofol;
  • Judge which patients are suitable for procedural sedation with propofol;
  • Modify your strategy for at risk patients;
  • Understand how to address adverse events following propofol sedation;
  • Address governance issues regarding propofol sedation in your department.
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References

  1. Swanson ER, Seaberg DC, Stypula RW, Troianos CA. Propofol for conscious sedation: a case series. Acad Emerg Med. 1995 Jul;2(7):661-3.
  2. Hohl CM, Sadatsafavi M, Nosyk B, et al. Safety and clinical effectiveness of midazolam versus propofol for procedural sedation in the emergency department: a systematic review. 2008. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.
  3. Green SM. Propofol in emergency medicine: further evidence of safety. Emerg Med Aust 2007;19:389-393.
  4. Green SM. Research advances in procedural sedation and analgesia. Ann Emerg Med. 2007 Jan;49(1):31-6.
  5. The Royal College of Emergency Medicine (RCEM) Best Practice Guideline, Procedural Sedation in the Emergency Department. August 2022.
  6. Miner JR, Burton JH. Clinical practice advisory: Emergency department procedural sedation with propofol. Ann Emerg Med. 2007 Aug;50(2):182-7, 187.e1.
  7. Royal College of Anaesthetists (RCoA): Guidelines for the Provision of Anaesthesia Services in the Non-theatre Environment 2024.
  8. Mathieu N, Jones L, Harris A, et al. Is propofol a safe and effective sedative for relocating hip prostheses? Emergency Medicine Journal 2009;26:37-38.
  9. Gagg J, Jones L, Shingler G, et al. Door to relocation time for dislocated hip prosthesis: multicentre comparison of emergency department procedural sedation versus theatre-based general anaesthesia. Emerg Med J. 2009 Jan;26(1):39-40.
  10. Frymann SJ, Cumberbatch GL, Stearman AS. Reduction of dislocated hip prosthesis in the emergency department using conscious sedation: a prospective study. Emerg Med J. 2005 Nov;22(11):807-9.
  11. Green SM, Andolfatto G, Krauss B. Ketofol for procedural sedation? Pro and con. Ann Emerg Med. 2011 May;57(5):444-8.
  12. Thorpe RJ, Benger J. Pre-procedural fasting in emergency sedation. Emerg Med J. 2010 Apr;27(4):254-61.
  13. Roback MG, Green SM, et al. Tracking and Reporting Outcomes Of Procedural Sedation (TROOPS): Standardized Quality Improvement and Research Tools from the International Committee for the Advancement of Procedural Sedation. Br J Anaesth. 2018 Jan;120(1):164-172. Fig.1

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