Patient-Controlled Sedation During Gynaecological Procedures-Aspects of Patient Satisfaction, Feasibility and Cost Per Patient: Empirical Research Quantitative.
Benjamin Grossmann, Fredrik Ahlström, Katri Nieminen
PMID 41267459WHAT IT FOUND
Patient-controlled propofol sedation allowed 128 gynaecological procedures to be completed safely without anaesthesiologists present.
Most patients reported no or mild pain, and 86% were very satisfied. Direct costs for IUD insertion were 85% lower when performed in the outpatient clinic rather than the day surgery unit.
Key findings
01128 gynaecological procedures were completed using patient-controlled sedation (PCS) with propofol without anaesthesiologists present.
02The majority of patients assessed their discomfort or pain as none or mild, and overall satisfaction was high (86% very satisfied).
03The mean cost per patient for IUD insertion was 85% lower when completed at the gynaecological clinic compared to the day-care surgical unit.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study design was descriptive and retrospective, with no inferential statistics or control group, so it cannot prove PCS is superior to other methods. Patient evaluation response rate was low (57%), meaning satisfaction data relies on fewer than half of the patients. The Likert scale instrument used for outcomes was not formally validated. The cost analysis was limited to a single procedure type (IUD insertion) and did not account for all potential economic factors. The study took place in a specific Swedish healthcare context with established training protocols, which may limit generalisability to other settings.
The easy way to misread this
Do not interpret the low complication rate as evidence that PCS is safe for all patients or in all settings. The study excluded high-risk patients (e.g., BMI ≥ 40, sleep apnea) and was conducted by specifically trained staff following strict protocols. The 7% failure rate due to technical issues also highlights a practical barrier to feasibility.