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Propofol is a short acting non-opioid anaesthetic agent that is suitable for deep sedation. It is not routinely recommended for conscious sedation. Propofol has no analgesic properties. It has a rapid onset of action, usually within 30 seconds. Its sedative duration depends on the initial bolus dose as well as the dose and timing of subsequent boluses. Due to its pharmacological properties, additional doses are cleared more slowly. Top-up boluses should therefore be smaller. It is well documented that the elderly are more sensitive to this drug than the young.

The use of propofol for procedural sedation in emergency medicine was first reported in 1995 [1]. Studies have since demonstrated a safety profile equivalent to benzodiazepine/opiate combinations [2]. Its safe use by emergency physicians has been established [3] and promoted [4]. A specific policy for propofol sedation was introduced by the American College of Emergency Physicians (ACEP) in 2007 [5].

The Royal College of Emergency Medicine (RCEM) (with the support of the Royal College of Anaesthetists (RCoA)) endorses the use of propofol by trained emergency physicians [6].

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