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Rwanda Medical Journal
Rwanda Health Communication Center - Rwanda Biomedical Center (RHCC - RBC)
ISSN: 2079-097X
EISSN: 2079-097X
Vol. 78, No. 4, 2021, pp. 27-31
Bioline Code: rw21025
Full paper language: English
Document type: Research Article
Document available free of charge

Rwanda Medical Journal, Vol. 78, No. 4, 2021, pp. 27-31

 en The utilization of procedural sedation and analgesia at the University Teaching Hospital of Kigali, Rwanda
Manirafasha, A.; Umuhire, O. F.; Muragizi, J.; Rosenberg, N. & Cattermole, N. G.


INTRODUCTION: In the Emergency Department (ED), safe and effective Procedural Sedation and Analgesia (PSA) is essential. The professional performing procedural sedation has to be prepared to handle any potential adverse effects. Medications are used according to their availability and based on the physician’s experience and preference. Despite the common occurrence of procedural sedation in the ED, it has not previously been studied in Rwanda.
The study aimed to describe procedural sedation and analgesia utilization and common adverse events at Rwanda's University Teaching Hospital of Kigali (UTH-K) ED.
METHODS: This study is a prospective observational study of procedural sedations done at UTH-K ED. The effectiveness of sedation was evaluated using the Richmond Agitation Sedation Score (RASS) during sedation. The pain scale was assessed before and after the procedure. Categorical data were analyzed for significant differences using Chi-squared (X) tests and continuous data with Mann-Whitney (MW) tests.
RESULTS: Two hundred fifty-one patients were recruited. Seventy-two percent (72%) of patients were male with a median age of 32 years (IQR 23to 40). The most commonly used analgesics included morphine (78%) and tramadol (17%), with ketamine least used (1%). A common adverse event was hypoxia (36%), followed by hallucination (8%). No adverse events were observed in 47% of procedures.
CONCLUSION: Our study findings suggest that although sedation in our low-resource setting did not result in serious adverse outcomes for patients, there was a much higher incidence of minor adverse events (especially hypoxia) than in higher-resource settings.

Procedural Sedation; Emergency Department; Adverse Events; Analgesia; Conscious Sedation

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