PMID- 23458140
OWN - NLM
STAT- MEDLINE
DCOM- 20160322
LR  - 20191027
IS  - 1481-8043 (Electronic)
IS  - 1481-8035 (Linking)
VI  - 15
IP  - 2
DP  - 2013 Mar
TI  - Do injection drug users have more adverse events during procedural sedation and 
      analgesia for incision and drainage of cutaneous abscesses?
PG  - 90-100
AB  - 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 -1.8, 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.
FAU - Xavier Scheuermeyer, Frank
AU  - Xavier Scheuermeyer F
FAU - Andolfatto, Gary
AU  - Andolfatto G
FAU - Lange, Lisa
AU  - Lange L
FAU - de Jong, Danielle
AU  - de Jong D
FAU - Qian, Hong
AU  - Qian H
FAU - Grafstein, Eric
AU  - Grafstein E
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - CJEM
JT  - CJEM
JID - 100893237
RN  - 0 (Hypnotics and Sedatives)
SB  - IM
MH  - Abscess/*surgery
MH  - Adult
MH  - Analgesia/*adverse effects
MH  - British Columbia/epidemiology
MH  - Conscious Sedation/*adverse effects
MH  - Drainage/*methods
MH  - *Drug Users
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypnotics and Sedatives/*adverse effects
MH  - Incidence
MH  - Male
MH  - Postoperative Complications/*epidemiology/etiology
MH  - Retrospective Studies
EDAT- 2013/03/06 06:00
MHDA- 2016/03/24 06:00
CRDT- 2013/03/06 06:00
PHST- 2013/03/06 06:00 [entrez]
PHST- 2013/03/06 06:00 [pubmed]
PHST- 2016/03/24 06:00 [medline]
AID - 10.2310/8000.2012.120710 [doi]
PST - ppublish
SO  - CJEM. 2013 Mar;15(2):90-100. doi: 10.2310/8000.2012.120710.