Comparative safety and sedation-related outcomes of fospropofol disodium versus propofol for adult sedation outside general anaesthesia induction or maintenance (including ICU and procedural sedation): a systematic review, meta-analysis and trial sequential analysis

This study compared the safety and efficacy of fospropofol disodium (a water-soluble prodrug of propofol) with propofol for sedation in adults outside the operating room, including intensive care unit and procedural sedation. The analysis included 12 randomized controlled trials. Compared with propofol, fospropofol disodium significantly reduced injection pain (OR 0.09) and during procedural sedation reduced respiratory adverse events (OR 0.19). However, fospropofol increased pruritus and paraesthesia (OR 32.56). During procedural sedation, fospropofol was associated with lower hypotension incidence (OR 0.24), but this benefit was not confirmed in continuous ICU sedation. Data on mortality, delirium, and ICU length of stay were insufficient for reliable conclusions. The certainty of evidence ranged from very low to moderate.