Sedation

Just curious if you have a preference for moderate / conscious sedation medications, and if you would share some experiences (good and bad) in the comments section about what has worked and what has not worked for you in the past.

The impression I get is that everyone loves ketamine for pediatric patients, and most people administer propofol for adult patients. Is this your practice? Do you use a one drug fits all approach for every patient, or does it depend on the procedure?

Have any of you had experience with alfentanil, remifentanil or Dexmedetomidine ? Was it good? bad?

Do you always give opiate medications prior to the actual sedation?

What are some of the reactions your patients have had to different sedation agents?

This is pure opinion, I think it will be nice to see what the rest of our colleagues are preferentially using in the ED for conscious sedation.  The greatest benefit would be from comments, but if you are too lazy, at least vote in the poll!