Target-controlled Infusion With Propofol in the Emergency Department : a Prospective Study on 45 Adult Patients
Status:
Unknown status
Trial end date:
2020-04-10
Target enrollment:
Participant gender:
Summary
Procedural sedation is an emergency medicine technique that provides a brief, deep sedation
in order to perform very painful emergency emergent procedures such as displaced fracture or
dislocated joints reduction. Propofol is recommended for this purpose, injected administered
in slow IV bolus injections according to the technique known as manual titration. But despite
this precaution, temporarily excessive sedation can happen, and a side effect can appear
(arterial hypotension or respiratory depression). Target-controlled infusion (TCI) is an
anesthesia technique that permits to obtain a precise constant and stable concentration of
medication, boluses volumes of injection being calculated and delivered automatically by an
electric syringe equipped with a software obedient to existing pharmacokinetic models. In the
operating room, Ffor anesthetic induction, maintenance and awakening, respectively, in the
operating room, the brain concentrations of propofol range respectively from 2 to 6 μg/mL, 2
to 4 μg/mL, and between 0.8 and 1.2 μg/mL, respectively. Since TCI has never been used in
emergency departments (ED), the brain propofol concentrations which are necessary for
sedation and awakening of the patient are not known and must be determined experimentally.
In this single-center, prospective, interventional study, safety and feasibility of TCI will
be studied in one ED with the primary objective of determining the brain propofol
concentrations necessary to reach the an optimal sedation in for patients with indications of
sustaining very painful orthopedic emergency emergent procedures