Adverse Events with Different Procedural Sedation Regimens in IV Drug Users

For procedural sedation and analgesia (PSA), intravenous drug users frequently require higher doses of analgesics and sedatives and have longer recovery times. To assess adverse event rates during PSA in such patients, researchers retrospectively identified 276 injection drug users who underwent PSA between 2006 and 2009 at two urban teaching hospitals in Canada.

The overall adverse event rate was 6.5%, with 22 events reported during 18 procedures. Sedation regimens included propofol, propofol-fentanyl, fentanyl-midazolam, ketamine-propofol 1:1, and ketamine-fentanyl. There were no adverse events when propofol was used alone. Adverse event rates ranged from 8% to 12% for the other sedation regimens. Events included hypotension with systolic …