Tags

Type your tag names separated by a space and hit enter

A randomized controlled trial comparing patient-controlled and physician-controlled sedation in the emergency department.
Ann Emerg Med. 2010 Nov; 56(5):502-8.AE

Abstract

STUDY OBJECTIVE

We compare patient-controlled sedation (PCS) and emergency physician-controlled sedation (EPCS) with respect to propofol requirements, depth of sedation, adverse events, recovery time, physician satisfaction, and patient satisfaction in emergency department (ED) patients requiring brief but painful procedures.

METHODS

One hundred sixty-six patients in this randomized controlled trial received propofol sedation according to one of 2 regimens: infusion of propofol at doses determined by the treating physician (EPCS group) or infusion of propofol with a patient-controlled infusion pump (PCS group). The PCS group received an initial physician-controlled bolus following by self-administered doses. Depth of sedation was assessed at 3-minute intervals. Adverse events were recorded as they occurred. Physician and patient satisfaction were recorded with 100-mm visual analog scales.

RESULTS

There was a nonsignificant trend toward lower total propofol doses with PCS relative to EPCS (medians 1.36 versus 1.60 mg/kg, respectively; median difference -0.15 mg/kg; 95% confidence interval of the difference -0.33 to 0.05 mg/kg; P=.14). Adverse events, requirement for treatment of adverse events, and recovery time did not differ in the 2 groups. Depth of sedation was lower in the PCS group. Procedural success, ease of procedure, and patient satisfaction were similar in both groups despite nearly twice as many patients recalling the procedure in the PCS group and 15% of patients requiring additional physician-administered doses in the PCS group.

CONCLUSION

Compared with EPCS, PCS demonstrated similar propofol dosing, safety, recovery, and satisfaction but resulted in lighter sedation. Propofol PCS appears safe and effective for ED procedures requiring moderate rather than deep sedation.

Authors+Show Affiliations

Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. anthony_bell@health.qld.gov.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20538368

Citation

Bell, Anthony, et al. "A Randomized Controlled Trial Comparing Patient-controlled and Physician-controlled Sedation in the Emergency Department." Annals of Emergency Medicine, vol. 56, no. 5, 2010, pp. 502-8.
Bell A, Lipp T, Greenslade J, et al. A randomized controlled trial comparing patient-controlled and physician-controlled sedation in the emergency department. Ann Emerg Med. 2010;56(5):502-8.
Bell, A., Lipp, T., Greenslade, J., Chu, K., Rothwell, S., & Duncan, A. (2010). A randomized controlled trial comparing patient-controlled and physician-controlled sedation in the emergency department. Annals of Emergency Medicine, 56(5), 502-8. https://doi.org/10.1016/j.annemergmed.2010.04.020
Bell A, et al. A Randomized Controlled Trial Comparing Patient-controlled and Physician-controlled Sedation in the Emergency Department. Ann Emerg Med. 2010;56(5):502-8. PubMed PMID: 20538368.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized controlled trial comparing patient-controlled and physician-controlled sedation in the emergency department. AU - Bell,Anthony, AU - Lipp,Trent, AU - Greenslade,Jaimi, AU - Chu,Kevin, AU - Rothwell,Sean, AU - Duncan,Alison, Y1 - 2010/06/11/ PY - 2009/10/13/received PY - 2010/04/19/revised PY - 2010/04/23/accepted PY - 2010/6/12/entrez PY - 2010/6/12/pubmed PY - 2010/11/13/medline SP - 502 EP - 8 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 56 IS - 5 N2 - STUDY OBJECTIVE: We compare patient-controlled sedation (PCS) and emergency physician-controlled sedation (EPCS) with respect to propofol requirements, depth of sedation, adverse events, recovery time, physician satisfaction, and patient satisfaction in emergency department (ED) patients requiring brief but painful procedures. METHODS: One hundred sixty-six patients in this randomized controlled trial received propofol sedation according to one of 2 regimens: infusion of propofol at doses determined by the treating physician (EPCS group) or infusion of propofol with a patient-controlled infusion pump (PCS group). The PCS group received an initial physician-controlled bolus following by self-administered doses. Depth of sedation was assessed at 3-minute intervals. Adverse events were recorded as they occurred. Physician and patient satisfaction were recorded with 100-mm visual analog scales. RESULTS: There was a nonsignificant trend toward lower total propofol doses with PCS relative to EPCS (medians 1.36 versus 1.60 mg/kg, respectively; median difference -0.15 mg/kg; 95% confidence interval of the difference -0.33 to 0.05 mg/kg; P=.14). Adverse events, requirement for treatment of adverse events, and recovery time did not differ in the 2 groups. Depth of sedation was lower in the PCS group. Procedural success, ease of procedure, and patient satisfaction were similar in both groups despite nearly twice as many patients recalling the procedure in the PCS group and 15% of patients requiring additional physician-administered doses in the PCS group. CONCLUSION: Compared with EPCS, PCS demonstrated similar propofol dosing, safety, recovery, and satisfaction but resulted in lighter sedation. Propofol PCS appears safe and effective for ED procedures requiring moderate rather than deep sedation. SN - 1097-6760 UR - https://www.unboundmedicine.com/medline/citation/20538368/A_randomized_controlled_trial_comparing_patient_controlled_and_physician_controlled_sedation_in_the_emergency_department_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0644(10)00440-3 DB - PRIME DP - Unbound Medicine ER -