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Randomized clinical trial comparing procedural amnesia and respiratory depression between moderate and deep sedation with propofol in the Emergency Department

Academic Emergency Medicine Feb 20, 2019

Schick A, et al. - Researchers determined the difference in procedural amnesia and adverse respiratory events (AREs) between the target sedation levels of moderate (MS) and deep (DS) procedural sedation via performing a prospective, randomized clinical trial of consenting adult patients planning to undergo DS with propofol between March 5, 2015, and May 24, 2017. Enrolling a total of 107 patients (54 randomized to target MS and 53 to DS), it was noted that the intended sedation level was not reliably achieved with targeting MS or DS. However, targeting MS led to lower ARE rates and fewer patients with multiple AREs, but with no difference in procedural recall. In line with previous reports, less AREs were evident in patients who achieved MS than those who achieved DS. This study suggests achievement of adequate amnesia with less need for supportive airway interventions with a target of MS than a target level of DS, despite the fact that it often does not result in intended sedation level.
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