Propofol for procedural sedation in children in the emergency department

被引:127
作者
Bassett, KE
Anderson, JL
Pribble, CG
Guenther, E
机构
[1] Univ Utah, Div Pediat Emergency Med, Primary Childrens Med Ctr, Sch Med, Salt Lake City, UT 84102 USA
[2] Univ Utah, Dept Pediat, Primary Childrens Med Ctr, Sch Med, Salt Lake City, UT 84102 USA
[3] Univ Utah, Dept Pediat Anesthesia & Crit Care, Primary Childrens Med Ctr, Sch Med, Salt Lake City, UT 84102 USA
关键词
D O I
10.1016/S0196-0644(03)00619-X
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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 (less than or equal to2 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.
引用
收藏
页码:773 / 782
页数:10
相关论文
共 47 条
[41]  
ROBACK MG, 2003, PED AC SOC M MAY 5
[42]  
SCHECHTER NL, 1989, PEDIATR CLIN N AM, V36, P781
[43]   HEMODYNAMIC-EFFECTS OF PROPOFOL IN CHILDREN [J].
SHORT, SM ;
AUN, CST .
ANAESTHESIA, 1991, 46 (09) :783-785
[44]   PROPOFOL FOR CONSCIOUS SEDATION - A CASE SERIES [J].
SWANSON, ER ;
SEABERG, DC ;
STYPULA, RW ;
TROIANOS, CA .
ACADEMIC EMERGENCY MEDICINE, 1995, 2 (07) :661-663
[45]   Is propofol safe for procedural sedation in children? A prospective evaluation of propofol versus ketamine in pediatric critical care [J].
Vardi, A ;
Salem, Y ;
Padeh, S ;
Paret, G ;
Barzilay, Z .
CRITICAL CARE MEDICINE, 2002, 30 (06) :1231-1236
[46]   Efficacy and safety of intravenous propofol sedation during routine ERCP: a prospective, controlled study [J].
Wehrmann, T ;
Kokabpick, S ;
Lembcke, B ;
Caspary, WF ;
Seifert, H .
GASTROINTESTINAL ENDOSCOPY, 1999, 49 (06) :677-683
[47]  
Yagiela J A, 2001, J Dent Educ, V65, P1348