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Critical Care

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

Keywords

Emergency DepartmentClinical EventVital SignOxygen SaturationProspective Trial
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, Alain, United Arab Emirates
(2)
Alain Hospital, Alain, AbuDhabi, United Arab Emirates

Copyright

© BioMed Central Ltd. 2007

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