Abstract
The practice of procedural sedation is expanding rapidly because minimally invasive surgery and interventional medical specialties are replacing conventional surgery, and increasingly these procedures can appropriately be done under sedation rather than general anesthesia. Patients prefer sedation techniques so the procedures can be accomplished with minimal discomfort and they can recover more rapidly and avoid the potential side effects of general anesthesia. The goals for a sedation technique are to provide sedation, analgesia and, as requested, amnesia. This requires a balance between patient comfort and safety, while preventing cardiovascular or respiratory compromise or delayed recovery. Propofol has been used for over two decades and has many properties ideally suited for procedural sedation. More recently, a new propofol prodrug, fospropofol disodium was also approved in the U.S. as a sedative. Fospropofol is formulated in aqueous solution and has some potential advantages over propofol. This review discusses the pharmacology and clinical uses of propofol and fospropofol, as well as the benefits and disadvantages of the two drugs when used for sedation.
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