Adverse events and outcomes of procedural sedation and analgesia in major trauma patients

Trauma patients requiring procedural sedation and analgesia (PSA) may have increased risk of adverse events (AEs) and poor outcomes. To determine the incidence of AEs in adult major trauma patients who received PSA and to evaluate their postprocedural outcomes. Retrospective analysis of adult patien...

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Bibliographic Details
Published in:Journal of emergencies, trauma and shock trauma and shock, 2015-10, Vol.8 (4), p.210-215
Main Authors: Green, Robert S, Butler, Michael B, Campbell, Samuel G, Erdogan, Mete
Format: Article
Language:English
Subjects:
Analgesia
Analysis
Emergency medicine
Health aspects
Original
outcomes
procedural
retrospective
sedation
trauma
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Summary:Trauma patients requiring procedural sedation and analgesia (PSA) may have increased risk of adverse events (AEs) and poor outcomes. To determine the incidence of AEs in adult major trauma patients who received PSA and to evaluate their postprocedural outcomes. Retrospective analysis of adult patients (age >16) who received PSA between 2006 and 2014 at a Canadian academic tertiary care center. We compared the incidence of PSA-related AEs in trauma patients with nontrauma patients. Postprocedural outcomes including Intensive Care Unit admission, length of hospital stay, and mortality were compared between trauma patients who did or did not receive PSA. Descriptive statistics and multivariable logistic regression. Overall, 4324 patients received PSA during their procedure, of which 101 were trauma patients (107 procedures). The majority (77%) of these 101 trauma patients were male, relatively healthy (78% with American Society of Anesthesiologists Physical Status [ASA-PS] 1), and most (85%) of the 107 procedures were orthopedic manipulations. PSA-related AEs were experienced by 45.5% of the trauma group and 45.9% of the nontrauma group. In the trauma group, the most common AEs were tachypnea (23%) and hypotension (20%). After controlling for age, gender, and ASA-PS, trauma patients were more likely than nontrauma patients to develop hypotension (odds ratio 1.79; 95% confidence interval 1.11-2.89). Although trauma patients were more likely than nontrauma patients to develop hypotension during PSA, their outcomes were not worse compared to trauma patients who did not have PSA.
ISSN:0974-2700
0974-519X
DOI:10.4103/0974-2700.166612