RN here, I’m not sure about procedural sedation since I only do conscious with versed and fentanyl, but in the ICU we use continuous propofol all the time to keep patients sedated and ventilated. While some do have a drop in blood pressure, it’s a titratable drug and therefore so are the effects. All depends on the person, and we have had to attempt other sedating medications for that reason. I’m fairly used to using it though and give boluses as needed without too much paranoia. These patients don’t all have art lines and half hour—hourly vitals is just fine. There’s nothing wrong with being cautious though, especially if this is a first administration for a procedure with a fairly decent bolus. I’ve never seen someone code from a bolus. I have given it in conjunction with pressors when there are no other good options for sedation and we know the patient is susceptible to it.