sedation/analgesia for procedures

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MLB2000

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What drug/combo of drugs would you guys recommend for relatively safe sedation/analgesia for common procedures done in a controlled setting (ER, ICU, etc..) such as LP, reductions for dislocations, and other short-duration procedures?

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By far the best single drug for intensely painful very short procedures is propofol used alone. But unless you are trained in using propofol, the liabilities for disaster could be high. I have used this drug in ED for fracture reduction, shoulder dislocations, etc with great success, saving a trip to the OR. But some hospitals restrict it's use to certain locations within the hospital.
 
At ASC's and in-office procedure suites I have set up, I usually see either/or Versed, Fentanyl, Propofol.

If RN's are pushing propofol you need to check state by state to see their rules and regs for RN's pushing Propofol. Also, some states have rules and regs. for the MD and RN giving moderate sedation. I just noticed Texas State Medical Board issued rules on this.

I just set-up an office procedure suite that uses solely Propofol and their patients are happy, and recover very quickly.

Makes for a quick turnover. :)


Jared
 
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