Recent advances in control of sedation

Procedural sedation is commonly employed in endoscopic procedures, and increasingly uses propofol. The use of propofol is commonly restricted to anesthesia providers, and this may increase the cost of care. Administration of propofol requires a special set of skills to deal with the variability of patient response and the consequences of improper dosing. This has stoked interest in the use of automated systems to reduce manpower costs associated with propofol. This article examines why propofol poses challenges for human control, and how various automated systems have been used to address these challenges. We examine target-controlled infusions, patient-controlled sedation, the SEDASYS System, and optimized ramp induction. The article emphasizes on how the various approaches deal with the range of variability in propofol response. No single system is capable of dealing with all patients without some human supervision and intervention.