title: Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation and analgesia in the emergency department.
abstract: The study compared the effectiveness of ketamine and midazolam/fentanyl as procedural sedation and analgesia agents for reduction of fractures and dislocated joints. Forty-one adult patients were enrolled by convenience sampling. They were randomized to receive ketamine or midazolam/fentanyl. Depth of sedation, pain score, procedural outcome and memory of the procedure were documented. The ketamine group had deeper sedation, but there was no statistical difference in other variables between the two groups. Three patients in the midazolam/fentanyl group had oxygen desaturation. More adverse effects were associated with ketamine. Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation.
authors: Emergency Department, Medical Faculty, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latiff, Cheras, 56000 Kuala Lumpur, Malaysia. suriazwa@gmail.com
authors: S M
authors: SM
authors: Jamal
authors: S M
authors: SM
authors: Fathil
authors: M M
authors: MM
authors: Nidzwani
authors: A K
authors: AK
authors: Ismail
authors: F M
authors: FM
authors: Yatim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D016292:Procedural Sedation; D004636:Emergency Service, Hospital; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D050723:Fractures, Bone / Q000150:complications / Q000628:therapy; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000628:therapy; D007649:Ketamine / Q000627:therapeutic use*; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D018686:Anesthetics, Intravenous; D007649:Ketamine; D008874:Midazolam; D005283:Fentanyl