Procedural Sedation and Analgesia in the Emergency Department: A Retrospective Evaluation

Yıl 2025, Cilt: 8 Sayı: 4, 165 - 170, 30.12.2025

Çağrı Safa Buyurgan , Akif Yarkaç , Seyran Bozkurt , Ataman Köse , Rohad Sadık Koyuncu , Ayşe Yılmaz , Gülhan Temel

https://doi.org/10.54996/anatolianjem.1724523

https://izlik.org/JA63SG83WD

Öz

Aim: This study aimed to describe the demographic and clinical characteristics of patients who underwent procedural sedation and analgesia (PSA) performed by emergency medicine physicians in the emergency department, and to evaluate adverse clinical outcomes (ACOs).
Material and Methods: Data of 308 patients who underwent PSA between March 1, 2024, and February 28, 2025, were retrospectively analyzed. Patients’ demographic data, types of procedures, agents used during PSA, and post-procedure complications were evaluated. ACOs were defined as complications occurring during or after PSA, and the need for intervention, requirement for ward or intensive care unit (ICU) admission, or death associated with these complications.
Results: PSA was most commonly performed in orthopedic procedures (96.1%) and in male patients (51.6%). Midazolam was the most frequently used sedative agent (75.0%), while the fentanyl–midazolam combination was the most preferred regimen (72.4%). No major cardiovascular, respiratory, or neurological complications were observed. One patient (0.3%) developed ketamine-related vomiting and a secondary allergic reaction to symptomatic treatment, and was discharged after ward observation. No ICU admission or death occurred.
Conclusion: Our findings demonstrate that PSA can be safely performed by emergency medicine physicians with a high success rate and minimal complications. Considering the side effects observed with the use of sedative agents alone, preferring combination therapies may be a more effective approach to reduce the risk of complications.

Anahtar Kelimeler

Adverse clinical outcome , analgesia , conscious sedation , emergency department , orthopedic procedures

Proje Numarası

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Acil Serviste Prosedürel Sedasyon ve Analjezi: Retrospektif Bir Değerlendirme

https://izlik.org/JA63SG83WD

Öz

Amaç: Bu çalışmada, acil serviste acil tıp hekimleri tarafından prosedürel sedasyon ve analjezi (PSA) uygulanan hastaların demografik ve klinik özelliklerinin tanımlanması ve olumsuz klinik sonlanımların (OKS) değerlendirilmesi amaçlandı.
Gereç ve Yöntemler: 01.03.2024–28.02.2025 tarihleri arasında PSA uygulanan 308 hastanın verileri retrospektif analiz edildi. Hastaların demografik verileri, girişim türleri, PSA sırasında kullanılan ajanlar ve işlem sonrası komplikasyonlar değerlendirildi. OKS; PSA uygulaması sırasında veya sonrasında gelişen komplikasyonlar ve bunlara bağlı olarak ortaya çıkan müdahale ihtiyacı, servis veya yoğun bakım yatışı gereksinimi ile ölüm durumu olarak tanımlandı.
Bulgular: PSA, en sık ortopedik girişimlerde (%96,1) ve erkek hastalarda (%51,6) uygulandı. Sedatif ajan olarak en çok midazolam (%75,0), kombinasyon tedavide ise en çok fentanil ve midazolam (%72,4) tercih edildi. PSA’ya bağlı ciddi bir kardiyovasküler, solunumsal veya nörolojik komplikasyon gözlenmedi. Sadece bir hastada (%0,3) ketamin kaynaklı kusma ve verilen semptomatik tedaviye sekonder alerjik reaksiyon gelişti. Bu hasta, noninvaziv yaklaşımla yeterli servis gözlemi sonrası taburcu edildi. Hiçbir hastada komplikasyona bağlı yoğun bakım yatışı ya da ölüm görülmedi.
Sonuç: Bulgularımız, PSA’nın acil tıp hekimleri tarafından yüksek başarı oranı ve minimal komplikasyonla güvenli bir şekilde uygulanabildiğini göstermektedir. Sedatif ajanların tek başına kullanımında gözlenen yan etkiler dikkate alındığında, bu ajanların kombinasyon halinde tercih edilmesi, komplikasyon riskini azaltmada daha etkili bir yaklaşım olabilir.

Anahtar Kelimeler

Olumsuz klinik sonlanım , analjezi , bilinçli sedasyon , acil servis , ortopedik girişimler

Proje Numarası

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Kaynakça

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