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Propofol sedation is sedation for medical procedures accomplished with the use of propofol, a hypnotic agent used to induce anesthesia and manage patients on mechanical ventilators. There are a number of advantages to using propofol for sedation, although there are also some safety concerns, as with any sedative, because these medications depress respiration, decrease blood pressure, and can cause clinical emergencies. In procedures where propofol is used, the patient needs to be monitored closely so interventions can be provided if distress develops.
This medication is sold in the form of an injectable solution. Propofol takes effect extremely rapidly, usually in less than a minute, and it clears the body very quickly. This allows patients undergoing propofol sedation to recover fast, returning to normal cognition and physical ability as soon as the procedure is often and administration of the medication is stopped. The use of this drug can also reduce the need for narcotic medications to manage pain, limiting potential side effects and keeping patients more comfortable.
Concerns with propofol surround its potentially depressive effect on the respiratory system. In surgery and intensive care units, the drug is primarily used on patients who have already been intubated to secure the airway. Propofol sedation may be administered to a patient who is breathing independently, and if respiratory distress occurs, it can be harder to intubate the patient to get adequate air into the lungs. Patients can also go into distress very fast because of the rapid action of this drug, and care providers need to be alert to falling blood pressure and other warning signs.
This sedation option is most commonly recommended for gastroenterology procedures where the patient needs to be sedated for comfort, but does not need to be fully anesthetized. Colonoscopy procedures are a common reason to need sedation. Some facilities prefer to use an anesthesiologist or nurse-anesthetist for propofol sedation, as these care providers have special training in the administration of anesthesia and the potential complications. Others may use a regular nurse.
When patients are preparing for sedation procedures, they can ask about the sedative available and the safety protocols used to protect them while they are under sedation. Patients should make sure to disclose any allergies. Some formulations of propofol, for example, contain both egg and soy, and a patient could potentially have a serious allergic reaction during administration of the drug. An acute allergic response during propofol sedation could be very dangerous, even in a medical facility where people are prepared to provide treatment.