In Reply We would like to thank Dr Pino for his feedback on our article,1 and we agree that our statement on the use of propofol for procedural sedation deserves some clarification. In his letter, Dr Pino outlines the complex pharmacologic properties of the drug, and he appropriately stresses the importance of its use only in skilled hands.
Our goal was to point out that procedural sedation can be safely achieved without intubation, and that this is commonly done using propofol in the emergency department setting. This was based off of a Level A recommendation in a 2014 policy update2 of the American College of Emergency Physicians. We did not mean to imply that propofol has analgesic properties.
Worsham C, Breu AC. The Safe Use of Propofol—Reply. JAMA Intern Med. 2016;176(1):140. doi:10.1001/jamainternmed.2015.7201