title: Comparison of midazolam and diazepam for conscious sedation in the emergency department.
abstract: OBJECTIVE
  To compare the efficacy of diazepam and midazolam when used for conscious sedation in emergency department patients.
  
  
  METHODS
  Prospective, randomized, double-blind, multicenter trial.
  
  
  METHODS
  Three university EDs.
  
  
  METHODS
  Patients requiring one of the following procedures: abscess drainage, joint reduction, extensive suturing, chest tube insertion, or lumbar puncture.
  
  
  METHODS
  Diazepam (2.5 mg/mL) or midazolam (1 mg/mL) was administered until the desired level of sedation was achieved to a maximum of 5 mL. Fentanyl citrate was administered if needed for pain.
  
  
  RESULTS
  Thirty-three patients received diazepam and 36 received midazolam. Patients receiving midazolam had a greater degree of early sedation (P < .05), a higher 90-minute alertness scale score (P < .05), more patients ready for discharge at 90 minutes (P = .05), significantly less recall for the procedure (P < .02), and less pain on injection (P < .01) than patients who were given diazepam.
  
  
  CONCLUSIONS
  Diazepam and midazolam are both effective for conscious sedation in ED patients. Midazolam causes less pain on injection, a significantly greater degree of early sedation, and a more rapid return to baseline function.
authors.affiliation: Vanderbilt University, Nashville, Tennessee.
authors.forename: S W
authors.initials: SW
authors.lastname: Wright
authors.forename: C R
authors.initials: CR
authors.lastname: Chudnofsky
authors.forename: S C
authors.initials: SC
authors.lastname: Dronen
authors.forename: R
authors.initials: R
authors.lastname: Kothari
authors.forename: P
authors.initials: P
authors.lastname: Birrer
authors.forename: D M
authors.initials: DM
authors.lastname: Blanton
authors.forename: A
authors.initials: A
authors.lastname: Bruner
mesh_terms: D000293:Adolescent; D000328:Adult; D016292:Procedural Sedation / Q000379:methods*; D003975:Diazepam / Q000009:adverse effects; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008874:Midazolam / Q000009:adverse effects; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D003975:Diazepam; D008874:Midazolam