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Noninvasive capnometry has been suggested as an adjunct to aid in detection of hypoventilation during emergency department procedural sedation and analgesia (PSA). Researchers performed a planned secondary analysis of capnography data from a trial in which low-dose ketamine–propofol was compared with fentanyl–propofol in 63 nonobese patients who underwent PSA without preoxygenation for orthopedic reduction or abscess drainage in a Canadian ED (JW Emerg Med Dec 24 2008). All patients were monitored with continuous capnography and pulse oximetry.
Thirty-six patients (57%) developed oxygen desaturation (defined as oxygen saturation <92%); all responded rapidly to supplemental oxygen, stimulation, and cessation of propofol. Nineteen patients (30…