Propofol for Procedural Sedation in Adults

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

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, a section on advanced procedural sedation 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.

References

  1. Swanson ER, Seaberg DC, Stypula RW et al. Propofol for conscious sedation: a case review [letter]. Acad Emerg Med 1995;2:661-663.
  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. Acad Emerg Med 2008;15:1-8.
  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;49:31-36.
  5. Miner JR, Burton JH. Clinical practice advisory: emergency department procedural sedation with propofol. Ann Emerg Med 2007;50:182-187.
  6. The Royal College of Anaesthetists. Safe Sedation of Adults in the Emergency Department. 2012.
  7. Matthieu N, Jones L, Harris A et al. Is propofol a safe and effective sedative for relocating hip prostheses? Emerg Med J 2009;26:37-38.
  8. 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;26:39-40.
  9. Fryman SJ, Cumberbatch GLA, Stearman ASL. Reduction of dislocated hip prosthesis in the emergency department using conscious sedation: a prospective study. Emerg Med J 2005;22:807-809.
  10. Green SM, Andolfatto G, Krauss B. Propofol for procedural sedation? Pro or Con? Ann Emerg Med 2011;57:444-448.
  11. Thorpe RJ, Benger J. Pre-procedural fasting in emergency sedation. Emerg Med J 2010;27:254-261.

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