Review ArticlesEffect of target-controlled propofol infusion to reduce the incidence of adverse events for procedural sedation in the emergency department: a systematic reviewBurton, Fiona M.a,,b; Lowe, David J.c; Millar, Jonathan E.d; Corfield, Alasdair R.e; Watson, Malcolm J.d; Shaw, Martinf; Sim, Malcolm A.B.b,,dAuthor Information aDepartment of Emergency Medicine, University Hospital Hairmyres, Lanarkshire bGlasgow University Section of Anaesthesia, Pain and Critical Care cDepartment of Emergency Medicine, Queen Elizabeth University Hospital dDepartment of Anaesthesia and Critical Care, Queen Elizabeth University Hospital, Glasgow eDepartment of Emergency Medicine, Royal Alexandra Hospital, Paisley fDepartment of Clinical Physics, Glasgow Royal Infirmary, Glasgow, Scotland Received 11 June 2019 Accepted 17 September 2019 Correspondence to Fiona M. Burton, MBChB, Emergency Department, University Hospital Hairmyres, Eaglesham Road, Glasgow, G75 8RG, UK, Tel: +44 0135 558 4103; e-mail: firstname.lastname@example.org European Journal of Emergency Medicine: August 2020 - Volume 27 - Issue 4 - p 253-259 doi: 10.1097/MEJ.0000000000000655 Buy Metrics Abstract The administration of propofol target-controlled infusion (TCI) for procedural sedation is standard in a range of hospital settings except for the Emergency Department (ED). Propofol TCI could be an alternative, safer way to provide procedural sedation in the ED compared with other methods of propofol administration. We compare the incidence of adverse events using propofol TCI compared with other methods of propofol administration. We conducted a systematic review of the literature from 1946 to January 2019 identifying studies that compared propofol TCI with other propofol regimens for procedural sedation in the adult population. Studies were assessed for risk of bias using the Cochrane Collaboration risk of bias tool. Seven articles were included. There was significant methodological heterogeneity in all aspects of study designs and definitions of adverse events which precluded a meta-analysis. A systematic review of the studies demonstrated fewer respiratory and cardiovascular adverse outcomes in three of the seven studies. It was not possible to determine if propofol TCI reduces the incidence of adverse events when compared with other sedating regimens using propofol using a descriptive systematic review of the relevant literature. Further research is required to compare the incidence of adverse events using propofol TCI for procedural sedation with other methods of administration in the ED. Future systematic reviews and meta-analysis comparisons would be aided by the use of standard adverse event reporting tools such as that of the Society of Intravenous Anaesthesia. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.