A randomized controlled trial comparing patient controlled versus physician controlled sedation in the Emergency Department.

Compare patient controlled sedation with doctor administered sedation for painful procedures performed in the Emergency Department.

Grant ID: EMSS-2008-002-BELL-RCT

Project Summary

Emergency Department patients are often sedated before undergoing painful procedures such as manipulation of fractures and dislocations. Propofol is a sedative drug commonly used for this purpose. Presently, the drug is always given by the doctor. However, there is evidence to suggest that the drug can be safely administered by the patient to him or herself. The patient does this by pressing a button on a pump which delivers the drug on demand in a controlled manner. This is called patient controlled sedation. There are potential benefits when the patient gives the sedative drug to him or herself including getting the dose and therefore the sedation just right, and the satisfaction of being in control. Patient controlled sedation will avoid the discomfort associated with the painful procedure if the doctor does not give enough of the drug. It will also avoid an overdose along with its associated side effects if the doctor gives too much of the drug.

This study will compare patient controlled sedation with doctor administered sedation for painful procedures performed in the Emergency Department. Eighty patients will be randomly assigned to the patient controlled sedation group and eighty patients to the doctor administered sedation group. The overall dose of propofol administered during patient controlled and doctor administered sedation will be compared. The study will also examine how deeply the patients are put to sleep, how long they are put to sleep, how satisfied they are with the sedation, and the number of adverse events, if any, between the two groups. The study has been approved the Human Research Ethics Committee of the Royal Brisbane and Women’s Hospital. Results of the study will be presented at scientific meetings and published in medical journals.

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Dissemination

Bell, A., Lipp, T., Greenslade, J., Chu, K., Rothwell, S. and Duncan, A., 2010. A randomized controlled trial comparing patient-controlled and physician-controlled sedation in the emergency department. Annals of emergency medicine, 56(5), pp.502-508.

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