• Barbara Muller, Arnaud Michalon, Adrien Reuillard, Anne Marie Holman, Bertrand Guihard, and Xavier Combes.
• Emergency Department, Hôpital Felix Guyon, Saint Denis, CHU de la Réunion.
• Eur J Emerg Med. 2020 Dec 1; 27 (6): 436-440.

ObjectivesPropofol is widely used today outside the operating room to facilitate painful procedures. The objective of this retrospective study was to evaluate the frequency and type of complications related to a propofol-based procedural sedation protocol used in a French emergency department.MethodsThis retrospective study reviewed the records over a 6-year period of all patients-adults and children-who received propofol for procedural sedation according to a pre-established protocol. The frequency and type of adverse events related to this sedation were recorded. Adverse events were classified according to the World Society of Intra-Veinous Anaesthesia International Sedation Task Force as sentinel, moderate, minor, or minimal.ResultsDuring the study period, 602 patients-395 adults (66%) and 207 (34%) children-received propofol. The main indications for procedural sedation were fracture (n = 327) and dislocation (n = 222) reduction, pleural drain placement (n = 34), and abscess incision (n = 12). Among the 602 consecutive cases, we identified 90 adverse events (14.9%; 95% confidence interval: 12-17.7%). These 90 events were classified as 1 sentinel (hypotension episode), 5 moderate (2 airway obstruction and 3 apnea episodes), 83 minor, and 1 minimal risk-averse events. There were no adverse outcomes.ConclusionNearly all of the adverse events in our series were minor. In the French medical system, the use of propofol outside the operating room by non-anesthesiologist physicians for procedural sedation appears safe.

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