title: Comparison of meperidine plus midazolam and fentanyl plus midazolam in procedural sedation: a double-blind, randomized controlled trial.
abstract: This double-blind, randomized, prospective study was conducted to compare the analgesic and sedative efficacy of fentanyl and meperidine in orthopedic closed reduction of fractures and dislocations undertaken in the emergency department. Seventy consecutive adult patients with fractures or dislocations suitable for reduction were randomized to receive fentanyl (1 mcg/kg; n = 36) or meperidine (0.5 mg/kg; n = 34) in combination with midazolam (0.02 mg/kg). Vital signs and alertness scale scores of the patients were monitored. The Visual Analog Scale (VAS) was used to determine the degree of pain. There was no statistically significant difference between the VAS mean scores of the fentanyl and meperidine groups (t test, P = .772). The need for additional analgesic drugs was significantly more frequent in patients receiving meperidine (P = .018). No adverse events, such as hypotension or respiratory depression, were noted. Euphoria occurred in one patient in the fentanyl group. Although dose requirements differ, fentanyl and meperidine provide effective and reliable analgesia in closed reduction of fractures and dislocations.
authors.affiliation: Dokuz Eylul University Medical School, Emergency Department, Inciralti, 35340, Izmir, Turkey.
authors.forename: Suna
authors.initials: S
authors.lastname: Soysal
authors.forename: Ozgur
authors.initials: O
authors.lastname: Karcioglu
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demircan
authors.forename: Hakan
authors.initials: H
authors.lastname: Topacoglu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Serinken
authors.forename: Niyazi
authors.initials: N
authors.lastname: Ozucelik
authors.forename: Kazim
authors.initials: K
authors.lastname: Tirpan
authors.forename: Ali
authors.initials: A
authors.lastname: Gunerli
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D016292:Procedural Sedation; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D050723:Fractures, Bone / Q000628:therapy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D004204:Joint Dislocations / Q000628:therapy; D008297:Male; D008614:Meperidine / Q000008:administration & dosage*; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D008614:Meperidine; D008874:Midazolam; D005283:Fentanyl