Emergency Procedural Sedation With Propofol in Older Teenagers: Any Cause for Concern?. Issue 11 (November 2015)

• Record Type: Journal Article
• Authors: Campbell, Samuel G.; MacPhee, Shannon; Butler, Michael; Zed, Peter J.; Froese, Patrick; Watson, Mary-Lynn; MacKinley, Robert
• Is Part Of: Pediatric emergency care. Volume 31:Issue 11(2015)
• Publication Date: 2015-11
• Subjects: procedural sedation -- propofol -- adverse drug events -- patient safety; Pediatric emergencies -- Periodicals; 618.92002505
• DOI: 10.1097/PEC.0000000000000447
• Languages: English
• ISSNs: 0749-5161

Abstract

Abstract : Introduction: Propofol is a standard for adult emergency department procedural sedation (EDPS). Use in pediatric patients remains controversial. Our primary objective was to investigate whether adverse events occurred more frequently in teenage pediatric patients receiving propofol for EDPS. Methods: This retrospective study examines records from the Halifax Procedural Sedation Registry, collected between January 1, 2006 and May 31, 2013. Patients undergoing EDPS using propofol were divided into those aged 16 to 19 years (teenagers), 20 to 65 years (adults), and older than 65 years (seniors). The primary outcomes were the incidences of hypotension and hypoxia. Results: Four thousand sixty-three EDPSs were included in the analysis, of which 230 involved teenagers, 2853 adults (mean age, 43.0 years), and 980 seniors (mean age, 77.1). The teenage group was significantly less likely to develop hypotension or hypoxia. These differences were confirmed on multivariate analysis. Patients in the teenage group received higher doses of propofol per kilogram/minute than the other groups. No other differences met statistical significance. Conclusions: Teenage patients receiving EDPS with propofol had a lower incidence of adverse events, and both received and tolerated larger adjusted doses of medication than older patients. Satisfaction and duration of EDPS were similar. Concerns about propofol use in younger patients have not been supported by this study. We believe that these findings support the use of propofol for EDPS in older teenagers.