Assessment of the Onset and Persistence of Amnesia during Procedural Sedation with Propofol

Abstract

There is a range of BIS scores during which sedated patients are able to repeat words read to them but are not able to subsequently recall these words. Furthermore, patients had no recall of words repeated prior to procedural sedation in BIS ranges associated with recall after procedural sedation, suggestive of retrograde amnesia.

Randomized, Double-Blinded, Clinical Trial of Propofol, 1:1 Propofol/Ketamine, and 4:1 Propofol/Ketamine for Deep Procedural Sedation in the Emergency Department

“…Propofol alone has been shown to be associated with procedural amnesia at the doses used in our study in the 100% propofol group and the 4:1 group. 42 Neither the dose of ketamine nor the dose of propofol in the 1:1 group has been demonstrated to produce procedural amnesia; however, our results suggest similar efficacy in this regard.…”

Efficacy of Fentanyl or Alfentanil in Suppressing Reflex Sneezing After Propofol Sedation and Periocular Injection

“…1,2,5,6 Propofol combined with midazolam and/or opioids has been shown to provide added efficacy in achieving adequate analgesia and amnesia prior to periocular injection. 7,8 Opioids and propofol, concomitantly for perioperative sedation, have been reported to be particularly useful in providing satisfactory conditions and limiting movement during retrobulbar anesthesia injections. 9, 10 We evaluate the efficacy of concomitant fentanyl or alfentanil on the incidence of the sneeze reflex associated with periocular local anesthesia injections and after propofol sedation.…”

Factors associated with patient‐reported procedural memory following emergency department procedural sedation with ketamine and propofol: A prospective cohort of 563 patients

“…[4][5][6]8 Typically, measuring recall requires unique cues during the tested amnestic period to determine whether new memories are being formed. 18,19 Our study and previous KP ED PSA research have really described patientreported memory. This is arguably a more patient-centred and clinically relevant outcome than recall but is prone to interviewer and recollection bias.…”

“…† †These groups were not mutually exclusive. 19 In further work, Miner et al compared a targeted moderate sedation to deep sedation for propofol ED PSA. Recall was 6/43 (14%) for deep sedation and 10/32 (31%) for moderate sedation (P = 0.07), and adverse respiratory events were similar for both groups.…”