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Titolo:
A combination of midazolam and ketamine for procedural sedation and analgesia in adult emergency department patients
Autore:
Chudnofsky, CR; Weber, JE; Stoyanoff, PJ; Colone, PD; Wilkerson, MD; Hallinen, DL; Jaggi, FM; Boczar, ME; Perry, MA;
Indirizzi:
Hurley Med Ctr, Dept Emergency Med, Flint, MI 48503 USA Hurley Med Ctr Flint MI USA 48503 Dept Emergency Med, Flint, MI 48503 USA Univ Michigan, Ann Arbor, MI 48109 USA Univ Michigan Ann Arbor MI USA 48109 iv Michigan, Ann Arbor, MI 48109 USA
Titolo Testata:
ACADEMIC EMERGENCY MEDICINE
fascicolo: 3, volume: 7, anno: 2000,
pagine: 228 - 235
SICI:
1069-6563(200003)7:3<228:ACOMAK>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRAMUSCULAR KETAMINE; PEDIATRIC PROCEDURES; CONSCIOUS SEDATION; TIME COURSE; DIAZEPAM; SAFETY; ANESTHESIA; EFFICACY; ANAESTHESIA; FENTANYL;
Keywords:
procedural sedation; procedural analgesia; ketamine; midazolam;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Chudnofsky, CR Hurley Med Ctr, Dept Emergency Med, 1 Hurley Plaza, Flint, MI 48503 USA Hurley Med Ctr 1 Hurley Plaza Flint MI USA 48503 48503 USA
Citazione:
C.R. Chudnofsky et al., "A combination of midazolam and ketamine for procedural sedation and analgesia in adult emergency department patients", ACAD EM MED, 7(3), 2000, pp. 228-235

Abstract

Objective: To describe the clinical characteristics of a combination of midazolam and ketamine for procedural sedation and analgesia in adult emergency department (ED) patients. Methods: This was a prospective, observationaltrial, conducted in the ED of an urban level II trauma center. Patients greater than or equal to 18 years of age requiring procedural sedation and analgesia were eligible, and enrolled patients received 0.07 mg/kg of intravenous midazolam followed by 2 mg/kg of intravenous ketamine. Vital signs were recorded at regular intervals. The adequacy of sedation, adverse effects,patient satisfaction, and time to reach discharge alertness were determined. Descriptive statistics were calculated using statistical analysis software. Results: Seventy-seven patients were enrolled. Three were excluded due to protocol violations, three due to lack of documentation, and one due to subcutaneous infiltration of ketamine, leaving 70 patients for analysis. The average age was 31 years, and 41 (59%) were female. Indications for procedural sedation and analgesia included abscess incision and drainage (66%), fracture/joint reduction (26%), and other (8%). The mean dose of midazolam was 5.6 +/- 1.4 mg and the mean dose of ketamine was 159 +/- 42 mg. The mean time to achieve discharge criteria was 64 +/- 24 minutes. Five patients experienced mild emergence reactions, but there were no episodes of hallucinations, delirium, or other serious emergence reactions. Eighteen (25%) patients recalled dreaming while sedated; twelve (17%) were described as pleasant, two (3%) unpleasant, three (4%) both pleasant and unpleasant, and one (1%) neither pleasant nor unpleasant. There were four (6%) cases of respiratory compromise, two (3%) episodes of emesis, and one (1% )case of myoclonia. All of these were transient and did not result in a change in the patient's disposition. Only one (1%) patient indicated that she was not satisfied with the sedation regimen. Conclusions: The combination of midazolam and ketamine provides effective procedural sedation and analgesia in adult ED patients, and appears to be safe.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 09:33:35