Safety profile of 1,008 cases of propofol sedation in the emergency department

Introduction

Until recently there were no guidelines for the reporting of adverse events (AEs) during procedural sedation [1, 2]. A consensus document released in 2012 by the world SIVA International Sedation Task Force proposed a benchmark for defining AEs [3]. We analysed 1,008 cases of procedural sedation in the emergency department.

Methods

The study is based on 1,008 patients who received procedural sedation with propofol in the emergency department between December 2006 and March 2012. Patients were selected and sedated to a strict protocol by ED consultant staff. We applied the AE tool by performing a search through patient records, discussion with consultants performing the sedation and consensus opinion.

Results

From 1,008 cases we identified 11 sentinel (six of hypotension, five cases of hypoxia), 34 moderate, 25 minor and three minimal risk adverse events.

Conclusion

The study shows a 1% adverse event rate. This supports use of propofol sedation by emergency physicians but within the limits of a strict governance framework. Our safety analysis using the World SIVA adverse events tool provides a reference point for further studies.