Annals of Emergency Medicine
Volume 52, Issue 1 , Pages 1-8 , July 2008

The Utility of Supplemental Oxygen During Emergency Department Procedural Sedation With Propofol: A Randomized, Controlled Trial

  • Kenneth Deitch, DO

      Affiliations

    • Corresponding Author InformationAddress for correspondence: Kenneth Deitch, DO, Department of Emergency Medicine, Albert Einstein Medical Center, Korman B-6, 5501 Old York Road, Philadelphia, PA 19141; 215-456-6679
  • ,
  • Carl R. Chudnofsky, MD
  • ,
  • Paul Dominici, MD

Received 3 October 2007 ,Revised 8 November 2007 ,Accepted 18 November 2007.

References 

  1. Chudnofsky CR, Lozon M. Sedation and analgesia for procedures. In:  Rosen P,  Marx JA,  Hockberger RS, et al. editor. Rosen's Emergency Medicine. 6th ed.. St. Louis, MO: Mosby Year Book; 2006;p. 2938–2955
  2. American Society of Anesthesiology. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 2002;96:1004–1017
  3. Jense HG, Dubin SA, Silverstein PI, et al. Effect of obesity on safe duration of apnea in anesthetized humans. Anesth Analg. 1991;72:89–93
  4. Patel R, Lenczyk M, Hannallah RS, et al. Age and the onset of desaturation in apnoeic children. Can J Anaesth. 1994;41:771–774
  5. American Academy of PediatricsAmerican Academy of Pediatric Dentistry. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update. Pediatrics. 2006;118:2587–2602
  6. Green SM. Research advances in procedural sedation and analgesia. Ann Emerg Med. 2007;49:31–36
  7. Deitch K, Chudnofsky CR, Dominici P. The utility of supplemental oxygen during emergency department procedural sedation and analgesia with midazolam and fentanyl: a randomized, controlled trial. Ann Emerg Med. 2007;49:1–8
  8. Miner JR, Biros MH, Heegaard W, et al. Bispectral electroencephalographic analysis of patients undergoing procedural sedation in the emergency department. Acad Emerg Med. 2003;10:638–643
  9. Havel CJ, Strait R, Hennes H. A clinical trial of propofol vs. midazolam for procedural sedation in a pediatric emergency department. Acad Emerg Med. 1999;6:989–997
  10. Symington L, Thakore S. A review of the use of propofol for procedural sedation in the emergency department. Emerg Med J. 2006;23:89–93
  11. De Jonghe B, Cook D, Appere-DeVecchi C, et al. Using and understanding sedation scoring systems: a systematic review. Intensive Care Med. 2000;26:275–285
  12. Miner JR, Biros M, Krieg S, et al. Randomized controlled trial of propofol versus methohexital for procedural sedation during fracture and dislocation reduction in the emergency department. Acad Emerg Med. 2003;10:931–937
  13. Bassett KE, Anderson JL, Pribble CG, et al. Propofol for procedural sedation in children in the emergency department. Ann Emerg Med. 2003;42:773–782
  14. Taylor DM, O'Brien D, Ritchie P, et al. Propofol versus midazolam/fentanyl for reduction of anterior shoulder dislocation. Acad Emerg Med. 2005;2:13–19
  15. Godambe SA, Elliot V, Matheny D, et al. Comparison of propofol/fentanyl versus ketamine/midazolam for brief orthopaedic procedural sedation in a pediatric emergency department. Pediatrics. 2003;112:116–123
  16. Guenther-Skokan E, Pribble C, Bassett KE, et al. Use of propofol sedation in a pediatric emergency department: a prospective study. Clin Pediatr (Phila). 2001;40:663–671
  17. Burton JH, Miner JR, Shipley ER, et al. Propofol for emergency department procedural sedation and analgesia: a tale of three centers. Acad Emerg Med. 2006;13:24–30
  18. Miner JR, Heegaard W, Plummer D. End-tidal carbon dioxide monitoring during procedural sedation. Acad Emerg Med. 2002;9:275–280
  19. Friesen RH, Alswang M. End-tidal CO2 monitoring via nasal cannulae in a pediatric emergency department: a prospective study. Clin Pediatr (Phila). 2001;40:663–671
  20. McNulty SE, Roy J, Torjman M, et al. Relationship between arterial carbon dioxide and end -tidal carbon dioxide when a nasal sampling port is used. J Clin Monit. 1990;6:93–98
  21. Anderson JL, Junkins E, Pribble C, et al. Capnography and depth of sedation during propofol sedation in children. Ann Emerg Med. 2007;49:9–13
  22. Burton JH, Harrah JD, Germann CA, et al. Does end-tidal carbon dioxide monitoring detect respiratory events prior to current sedation monitoring practices?. Acad Emerg Med. 2006;13:500–504
  23. Krauss B, Hess DR. Capnography for procedural sedation in the emergency department. Ann Emerg Med. 2007;50:172–181

 Supervising editor: Steven M. Green, MD

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that may create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Author contributions: KD and CRC conceived the study and designed the trial. KD, CRC, and PD supervised the conduct of the trial and data collection. KD, CRC, and PD managed the data, including quality control. PD provided statistical advice on study design and analyzed the data. KD drafted the article. CRC provided editorial support and contributed substantially to its revisions. KD takes responsibility for the paper as a whole.

 Earn CME Credit: Continuing Medical Education for this article is available at: www.ACEP-EMedHome.com.

 Reprints not available from the authors.

 Publication dates: Available online March 4, 2008.

PII: S0196-0644(07)01859-8

doi: 10.1016/j.annemergmed.2007.11.040

Annals of Emergency Medicine
Volume 52, Issue 1 , Pages 1-8 , July 2008