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Ann Emerg Med. 2003 Dec;42(6):773-82.

Propofol for procedural sedation in children in the emergency department.

Author information

1
Division 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

Abstract

STUDY OBJECTIVE:

We determine the safety and efficacy of propofol sedation for painful procedures in the emergency department (ED).

METHODS:

A consecutive case series of propofol sedations for painful procedures in the ED of a tertiary care pediatric hospital from July 2000 to July 2002 was performed. A sedation protocol was followed. Propofol was administered in a bolus of 1 mg/kg, followed by additional doses of 0.5 mg/kg. Narcotics were administered 1 minute before propofol administration. Adverse events were documented, as were the sedation duration, recovery time from sedation, and total time in the ED.

RESULTS:

Three hundred ninety-three discrete sedation events with propofol were analyzed. Procedures consisted of the following: fracture reductions (94%), reduction of joint dislocations (4%), spica cast placement (2%), and ocular examination after an ocular burn (0.3%). The median propofol dose was 2.7 mg/kg. Ninety-two percent of patients had a transient (<or=2 minutes) decrease in systolic blood pressure without clinical signs of poor perfusion. Nineteen (5%) patients had hypoxia, 11 (3%) patients required airway repositioning or jaw-thrust maneuvers, and 3 (0.8%) patients required bag-valve-mask ventilation. No patient required endotracheal intubation.

CONCLUSION:

Propofol sedation is efficacious and can be used safely in the ED setting under the guidance of a protocol. Transient cardiopulmonary depression occurs, which requires vigilant monitoring by highly skilled practitioners. Propofol is well suited for short, painful procedures in the ED setting.

PMID:
14634602
DOI:
10.1016/s0196-0644(03)00619-x
[Indexed for MEDLINE]

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