Short-acting agents for procedural sedation and analgesia in Canadian emergency departments: a review of clinical outcomes and economic evaluation
Bond K, Fassbender K, Karkhaneh M, Spooner C, Horton J, Sivilotti MLA, Campbell SG, Vandermeer B, Tjosvold L, Seal R, Rowe BH
Record ID 32008100101
English, French
Authors' objectives:
Review of Short-acting agents for procedural sedation and analgesia (PSAs) propofol, ketamine HCl, etomidate, and ketamine combined with low-dose propofol (ketofol).
Authors' recommendations:
Implications for Decision Making• Clear differences exist between short-acting and traditional agents. Short-acting agents are at least as effective as other regimens in terms of procedural success and clearly moreeffective in terms of reduced procedure time. With the exception of etomidate, short-acting agents were associated with no additional risk of minor adverse events (AEs) (and some may argue fewer risks of AEs).• Short-acting agents are associated with reduced costs. Propofol, etomidate, ketamine, and ketofol yield cost savings per procedure of $335.70, $301.76, $244.41, and $243.47respectively, compared with standard therapy. Etomidate generates the greatest savings from a time and labour costing perspective, but savings associated with propofol are greaterbecause the differences in costs from hospitalization and AE rates more than offset the differences in labour costs.• Opportunities for optimal usage exist. A survey of Canadian EDs revealed traditional agents are still in common usage. Opportunities may exist for the use of these agents by clinicians with less experience (e.g., rural physicians and nonphysician extenders, such as nurse practitioners and paramedics), given enough guidance or training.
Authors' methods:
Review
Details
Project Status:
Completed
Year Published:
2008
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Analgesia
- Analgesics, Opioid
Contact
Organisation Name:
Canadian Agency for Drugs and Technologies in Health
Contact Address:
600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
Contact Name:
requests@cadth.ca
Contact Email:
requests@cadth.ca
Copyright:
Canadian Agency for Drugs and Technologies in Health (CADTH)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.