Propofol for emergency department procedural sedation and analgesia: a tale of three centers

Acad Emerg Med. 2006 Jan;13(1):24-30. doi: 10.1197/j.aem.2005.08.011. Epub 2005 Dec 19.


Objectives: To characterize propofol procedural sedation and analgesia (PSA) encounters for a large patient population at multiple emergency department (ED) sites. The authors sought to assess the frequency of respiratory and cardiovascular events during propofol PSA within these settings.

Methods: This study was a prospective, descriptive series of a consecutive sample of ED patients receiving propofol for PSA at three study sites. Patients were monitored for PSA-related events, including predefined clinically relevant cardiovascular and respiratory events. Data collection was performed during PSA with a standardized data collection sheet unique to each site.

Results: Propofol was administered during PSA to 792 patients during the respective reporting period at each center. Indications for sedation included dislocation reduction (38%), cardioversion (10%), fracture reduction (35%), abscess incision and drainage (8%), computed tomography imaging (2%), and tube thoracostomy (1%). The cumulative rate of oxygen desaturation events for all study sites was 7.7% with a brief period of assisted ventilation with bag-valve mask in 3.9%. The cumulative rate of PSA-related hypotensive events was 3.5%. Increasing patient age and specific clinical procedure were clinical variables most associated with any propofol-related respiratory event. All PSA-related events resolved with supportive interventions during the PSA encounter. No patients required endotracheal intubation, prolonged observation, or admission for PSA-related complications.

Conclusions: Propofol typically confers a deep sedation experience for ED PSA. The most common PSA events associated with propofol are respiratory related and appear consistent across these three practice settings. All propofol-related PSA events resolved with brief supportive interventions in the ED with no adverse sequelae.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesia / statistics & numerical data*
  • Antiemetics / therapeutic use
  • Child
  • Child, Preschool
  • Conscious Sedation / statistics & numerical data*
  • Dose-Response Relationship, Drug
  • Emergency Medicine / statistics & numerical data
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Hypotension / chemically induced
  • Infant
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Propofol / therapeutic use*
  • Prospective Studies
  • Respiratory Insufficiency / chemically induced
  • United States
  • Vomiting / chemically induced
  • Vomiting / drug therapy


  • Antiemetics
  • Hypnotics and Sedatives
  • Propofol