Sixty studies were included in the review (n=17,066 propofol sedations): 20 RCTs and the rest appeared to be case series. For RCTs, only 18% of studies had adequate blinding, 24% had adequate concealment of allocation and 47% had adequate baseline comparability. Outcome measures were clearly defined in 76% of studies.
Incidences of adverse events of propofol for procedural sedation were: desaturation 9.3%, apnoea 1.9%, assisted ventilation 1.4%, hypotension 15.4%, unplanned intubation 0.02%, emesis post procedure 0.14%, laryngospasm 0.2%, bradycardia 0.1% and myoclonus 0.13%.
No incidents of aspiration or emesis during sedation were reported. There were no deaths associated with procedural propofol sedation.
The results of separate analyses of adverse events in RCTs were: desaturation 13.8%, apnoea 3.2% and assisted ventilation 1.4%.