title: Sedative and Analgesic Effects of Entonox Gas Compared with Midazolam and Fentanyl in Synchronized Cardioversion.
abstract: The purpose of this study was to determine if the Entonox gas could cause adequate analgesic and sedative effects in patients who need cardioversion. In this randomized not blinded clinical trial, the sedative and analgesic effects of midazolam and fentanyl were compared with Entonox. Eligible patients who need synchronized cardioversion because of dysrhythmia were randomly divided into two groups. The first group received intravenous midazolam and fentanyl; the second group received Entonox through a blower-dependent mask. Onset and end of sedation, sedation level, and pain score were recorded. There were nonsignificant differences between the two groups (22 patients in each group) regarding age, gender, weight, sedation level, and frequency and level of shock. The pain score recorded in the first group was 5.05 ± 1.32, and 3.9 ± 0.7 in the second group (P = 0.002). Furthermore, sedation duration and time to full recovery consciousness were shorter in the second group (P < 0.001). In the first group, seven patients needed additional doses to induce and maintain sedation. In addition, as a result of apnoea, four patients required airway support. None of them occurred in the second group. Entonox is a suitable medication in rapid cardioversion, as it has minimal side effects and adequate analgesic and sedative effects.
authors.affiliation: Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6193673166, Iran.
authors.forename: Kambiz
authors.initials: K
authors.lastname: Masoumi
authors.affiliation: Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6193673166, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Forouzan
authors.affiliation: Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman 7616914115, Iran.
authors.forename: Sina
authors.initials: S
authors.lastname: Saghari
authors.affiliation: Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6193673166, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Feli
authors.affiliation: Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6193673166, Iran.
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Sattari
authors.affiliation: Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6193673166, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Asgari Darian