NDLI: Is it safe to use propofol in the emergency department? A randomized controlled trial to compare propofol and midazolam

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Is it safe to use propofol in the emergency department? A randomized controlled trial to compare propofol and midazolam

Content Provider	Springer Nature : BioMed Central
Author	Rahman, Nik Hisamuddin Nik Ab Hashim, Ahmad
Abstract	Background This study examined the safety and effectiveness of the procedural sedation analgesia (PSA) technique carried out in the emergency department (ED) of a university hospital over a period of 1 year. The research was done to compare the effectiveness and efficacy of moderate sedation of fentanyl combined with either midazolam or propofol for any brief, intense procedure in the ED setting. Aims The objectives were to observe the occurrence of adverse events in subjects undergoing PSA for intense and painful procedures in the emergency department and to implement the use of capnography as a method of monitoring the patients when they were under PSA. Methods Forty patients were selected for this study. They were randomly divided into two equal groups using the computer-generated random permuted blocks of four patients. Twenty patients were grouped together as group A and the remaining 20 patients as group B. Drugs used were single blinded to prevent any bias. Drug A was propofol and fentanyl, while drug B was midazolam and fentanyl. The procedures involved included orthopedic manipulation such as reduction of fractures, reduction of dislocated joints, abscess drainage, wound debridement, laceration wound repair and cardioversion. All of the subjects were monitored for their vital signs and end tidal carbon dioxide level every 10 min till the PSA was completed. The duration of stay in the ED was documented when the subjects had completed the procedure and were released from the department. Result Of the study population, 75.6% were males. The mean age was 37.8 years (95% CI 33.2, 39.8). None of the patients developed any major complications while under PSA. The vital signs pre-, intra- and post-procedure were not significantly different in either the propofol or mizadolam groups (p value >0.05). Conclusion This study had proven that there was no difference in adverse event occurrence between the studied drugs during PSA. Propofol can be recommended for use in PSA if the operator is well trained and familiar with the drug.
Related Links	https://intjem.biomedcentral.com/counter/pdf/10.1007/s12245-010-0162-3.pdf
Ending Page	113
Page Count	9
Starting Page	105
File Format	HTM / HTML
ISSN	18651380
DOI	10.1007/s12245-010-0162-3
Journal	International Journal of Emergency Medicine
Issue Number	2
Volume Number	3
Language	English
Publisher	BioMed Central
Publisher Date	2010-03-25
Access Restriction	Open
Subject Keyword	Emergency Medicine Internal Medicine Cardiology Angiology Pediatrics Procedural sedation analgesia Midazolam Propofol Emergency department
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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