Volume 11 Supplement 2

27th International Symposium on Intensive Care and Emergency Medicine

Open Access

Evaluation of two sedation techniques in a casualty department

  • M Moustafa1 and
  • M Borai2
Critical Care200711(Suppl 2):P422

https://doi.org/10.1186/cc5582

Published: 22 March 2007

We compare the efficacy, adverse events, and recovery duration of etomidate and propofol for use in procedural sedation in the emergency department (ED). A randomized nonblinded prospective trial of adult patients undergoing procedural sedation for painful procedures in the ED was made. Patients received either propofol or etomidate. Doses, vital signs, nasal end-tidal CO2 (etco2), pulse oximetry, and bispectral electroencephalogram analysis scores were recorded. Subclinical respiratory depression was defined as a change in etco2 greater than 10 mmHg, an oxygen saturation of less than 92% at any time, or an absent etco2 waveform at any time. Clinical events related to respiratory depression, including an increase in supplemental oxygen, the use of a bag-valve-mask apparatus, airway repositioning, or stimulation to induce breathing, were noted. Etomidate and propofol appear equally safe for ED procedural sedation. Etomidate had a lower rate of procedural success and induced myoclonus in 20% of patients (see Table 1).
Table 1

abstract P422

Agent

Etomidate (n = 53)

Propofol (n = 55)

Subclinical respiratory depression

Yes (n = 18)

No (n = 35)

Yes (n = 23)

No (n = 32)

Increased supplemental oxygen

1/9 (2.1, 0.9–11.2)

2/34 (2.9, 0.8–7.2)

2/23 (4.4, 1.2–14.4)

1/32 (1.6, 0.2–5.5)

Bag-valve mask (%)

2/18 (6.9, 1.9–13.9)

0/34 (0, 0–2.3)

2/23 (4.4, 1.4–11.9)

0/32 (0, 0–2.7)

Airway repositioning

3/18 (9.7, 2.9–16.0)

3/34 (5.1, 1.4–8.7)

3/23 (6.5, 1.5–11.6)

3/31 (4.7, 1.1–8.0)

Stimulation to induce breathing

4/18 (11.1, 5.1–19.6)

2/34 (2.9, 0.8–7.1)

3/23 (7.6, 3.2–14.5)

3/31 (4.7, 1.8–9.6)

Authors’ Affiliations

(1)
Faculty of Medicine, Assiut University
(2)
Alain Hospital

Copyright

© BioMed Central Ltd. 2007

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