• Psychology
• patient support

We read with interest the clinically based study of Mathieu et al on the use of propofol to sedate patients for relocation of hip prostheses in the emergency department.1 The authors rightly point out that there are problems with the safety and efficacy of using midazolam, and conclude that the described technique is effective and safe. In another paper by the same authors, they demonstrate that this technique of ‘sedation’ has a better success than midazolam and reduces the delay in these patients going to theatre and therefore the discomfort the patients may experience (although there is no mention of pain scores of these patients).2 However, we disagree strongly with the conclusions that the adverse effects were acceptably uncommon and argue that the authors have not demonstrated the safety of this technique.

First, we would like to comment on the sedation protocol. Disappointingly there is no attempt to describe the depth of sedation provided. The report of the Academy of Royal Colleges …