On December 30, 2011, MDNews.com published an article outlining that procedural sedation with propofol saves time in comparison with midazolam/ketamine sedation. The article references a study published in the December 21 issue of The Journal of Bone & Joint Surgery. The study analyzed the recovery time, total sedation time, and the adverse events of procedural sedation and analgesia induced with propofol as compared with midazolam/ketamine. The study authors found that propofol saves time when compaed with the other sedatives.
Analysis:
The researchers found that the average recovery time after sedation for the patients who received propofol was (7.8 ? 3.7 minutes) compared with those who received midazolam/ketamine (30.7 ? 10.1 minutes). The rates of respiratory and hemodynamic adverse events were 20% (propofol) and 10% (midazolam/ketamine). “The use of propofol for an orthopedic procedure requiring sedation in the emergency department expedites patient management and saves time in comparison with the use of midazolam/ketamine,” concluded the study authors.
Marketed by AstraZeneca as Diprivan, propofol is a sedative-hypnotic agent used for the induction and maintenance of anesthesia, to produce loss of consciousness before and during surgery. Diprivan works by blocking nerve impulses. Marketed by AstraZeneca, Diprivan was first approved by the FDA on October 2, 1989. On June 15, 2007, the FDA informed health care professionals about the risk of patients experiencing chills, fever, and body aches shortly after receiving propofol for sedation or general anesthesia.
Versed (midazolam) is a short-acting drug in the benzodiazepine class used for treatment of acute seizures and for inducing sedation and amnesia before medical procedures. Versed works by slowing brain activity to allow relaxation and sleep.
Ketamine is an anesthetic used in humans in pediatric and obstetric procedures and as an animal tranquilizer. It was approved by the FDA in 1970?for both human and veterinary use. Ketamine is often abused as a recreational drug.
Using data from AERS aggregated and standardized by the AdverseEvent RxFilter process, we analyzed the reported adverse events for Diprivan (propofol), Versed (midazolam), and Ketamine.
We identified 2,132 patients who reported adverse events while taking Diprivan?from??01/01/2004 to 6/30/2011. The top three adverse events reported were hypotension (low blood pressure), propofol infusion syndrome, and pyrexia (fever).
We identified?659 patients who reported adverse events while taking?Versed?from 01/01/2004 to 6/30/2011. The top three adverse events reported were drug ineffective, hypotension (low blood pressure), and medication error.
We identified 74 patients who reported adverse events while taking Ketamine?from 01/01/2004 to 6/30/2011. The top three adverse events reported were drug abuse, medication error, and bradycardia (slow heart rate).
