Objective: Injection drug users (IDUs) often undergo procedural sedation and analgesia (PSA) in the emergency department (ED). We compared adverse events (AEs) for IDUs to those for non-IDUs receiving PSA for incision and drainage of cutaneous abscesses. Methods: This was a retrospective analysis of a PSA safety audit. IDU status was prospectively documented among consecutive patients undergoing PSA at two urban EDs. Structured data describing comorbidities, vital signs, sedation regimens, and adverse events were collected. Primary outcome was the proportion of patients in each group experiencing an AE, whereas the secondary outcomes included recovery times. Results: Of 525 consecutive patients receiving PSA for incision and drainage of an abscess, 244 were deemed IDUs and 281 non-IDUs. IDUs received higher doses of sedatives and analgesics, and 14 experienced AEs (5.7%), whereas 10 non-IDUs had AEs (3.6%), for a risk difference of 2.1% (95% CI 21.8, 6.5). Median recovery times were 18 minutes (interquartile range [IQR] 10-36) for IDUs and 12 minutes (IQR 7-19) for non-IDUs, for a difference of 6 minutes (95% CI 2-9 minutes). Median sedation times were also longer in IDUs, for a difference of 6 minutes (95% CI 5-10 minutes). Of 20 IDU patients and 1 non-IDU patient admitted to hospital, none had experienced an AE related to PSA. Conclusions: For ED patients requiring PSA for incision and drainage, IDUs had an AE rate similar to that of non-IDUs but longer sedation and recovery times. In experienced hands, PSA may be as safe in IDUs as in patients who do not use injection drugs. RÉ SUMÉObjectif: Les utilisateurs de drogues injectables (UDI) subissent souvent des interventions sous sé dation-analgé sie (SA) aux services des urgences (SU). L'é tude visait à comparer les é vé nements indé sirables (EI) de la SA chez les UDI avec ceux observé s chez les non-UDI, pour l'incision et le drainage d'abcè s cutané s. Mé thode: Il s'agit d'une analyse ré trospective d'une vé rification sur l'innocuité de la SA. La situation d'UDI a é té é tablie de maniè re prospective parmi des patients consé cutifs ayant subi une SA dans deux SU urbains, et il y a eu collecte de donné es structuré es sur les affections concomitantes, les signes vitaux, la posologie des sé datifs administré s, et les é vé nements indé sirables. Le principal critè re d'é valuation é tait la proportion de patients dans chaque groupe qui avait é prouvé des EI, et les critè res d'é valuation secondaires comprenaient, entre autres, le temps de ré veil. Ré sultats: Sur 525 patients consé cutifs, ayant subi une SA pour l'incision et le drainage d'un abcè s, 244 é taient considé ré s comme des UDI et 281, comme des non-UDI. Les UDI ont reç u des doses plus fortes de sé datifs et d'analgé siques, et 14 ont é prouvé des EI (5.7 %), tandis que 10 non-UDI ont connu des EI (3.6 %), soit une diffé rence de risques de 2.1 % (IC à 95 % 21.8, 6.5). Pour ce qui est du temps mé dian de ré veil, celui-ci é tait de 18 minutes (intervalle interquartile [II]: 10-36) chez...
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