Age Effect on Efficacy and Side Effects of Two Sedation and Analgesia Protocols on Patients Going through Cardioversion: A Randomized Clinical Trial

Parlak, Melih; Parlak, İsmet; Erdur, Bülent; Ergin, Ahmet; Sağıroğlu, Emel

doi:10.1197/j.aem.2005.12.013

Cited by 31 publications

(30 citation statements)

References 29 publications

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“…All but one trial reported withdrawals from the study. [10][11][12] However, the one that did not had no losses to followup. 6 Two trials reported a method for allocation concealment, but neither described the method in sufficient detail to ensure adequate concealment.…”

Section: 12mentioning

confidence: 99%

“…We found 4 RCTs that reported head-to-head comparisons of midazolam and propofol in the ED setting that could be used for the analysis of AEs and clinical effectiveness. 6,[10][11][12] We found 9 additional RCTs that did not report direct comparisons between the study drugs, but in which either midazolam or propofol had been studied and could be included in the analysis of AEs. 2,5,21,22,[29][30][31][32][33][34] An additional 15 observational studies met inclusion criteria for the analysis of AEs.…”

Section: Trial Flowmentioning

confidence: 99%

“…[10][11][12] Indications for PS were orthopedic reductions (111 ⁄ 228 patients), 10,12 cardioversion (107 ⁄ 228 patients), 6,11 I&D, and chest tube insertions. 10 Doses of study medications varied, and those trials that reported the most conservative dosing regimen for midazolam, 10 or no dosing regimen at all, 12 reported lower proportions of successful PS.…”

Section: Study Characteristics Of Rcts Comparing Midazolam and Propofmentioning

confidence: 99%

“…6,11,12 None of the trials were double-blinded. Two trials reported detailed methods on blinding of the outcomes assessor, 11,12 but neither stated explicitly that the patient had been blinded to treatment allocation and could therefore not be considered double-blinded. All but one trial reported withdrawals from the study.…”

Section: 12mentioning

confidence: 99%

“…Propofol remains more expensive, but is preferred by many physicians because it is associated with good patient relaxation and shorter recovery times. 6,[10][11][12] In contrast, some practitioners favor midazolam because they believe it may be associated with a lower risk of major AEs. 13,14 If, in fact, one of the two agents is associated with a more favorable safety profile and ⁄ or greater clinical effectiveness, the use of the superior agent should be encouraged.…”

mentioning

confidence: 99%

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Safety and Clinical Effectiveness of Midazolam versus Propofol for Procedural Sedation in the Emergency Department: A Systematic Review

Hohl

Sadatsafavi²,

Nosyk³

et al. 2008

Academic Emergency Medicine

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Objectives: To synthesize the evidence comparing the adverse event (AE) profile and clinical effectiveness of midazolam and propofol for procedural sedation (PS) in adults in the emergency care setting. Methods:The authors conducted a systematic review of randomized controlled trials (RCTs) and observational studies reporting the use of either midazolam and ⁄ or propofol for adult PS in the emergency department (ED). A systematic search strategy was developed and applied to six bibliographic reference databases. Three emergency medicine journals, the Canadian Adverse Drug Reaction Newsletter, and conference proceedings were hand-searched. Retrieved articles were reviewed and data were abstracted using standardized data collection. Trial quality was assessed using the Jadad score. The outcomes assessed were the proportion of patients with AEs and the pooled mean difference in the proportion of patients with successful PS.Results: Of 229 articles identified, 28 met the inclusion criteria for the analysis of AEs. Only one major AE to PS was found, resulting in no statistically significant difference in the proportion of major AEs between agents. Four studies were RCTs that met the inclusion criteria for the analysis of clinical effectiveness. Two trials met criteria for good quality. The RCTs enrolled between 32 and 86 patients, and the most common indications for PS were orthopedic reductions and cardioversions. There was a nonsignificant difference in the proportion of patients with successful PS in favor of propofol (effect difference 2.9%, 95% confidence interval (CI) = -6.5 to 15.2). Conclusions:The authors found no significant difference in the safety profile and the proportion of successful PS between midazolam and propofol for adults in the ED.ACADEMIC EMERGENCY MEDICINE 2008; 15:1-8 ª

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Section: 12mentioning

confidence: 99%

Section: Trial Flowmentioning

confidence: 99%

Section: Study Characteristics Of Rcts Comparing Midazolam and Propofmentioning

confidence: 99%

Section: 12mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Safety and Clinical Effectiveness of Midazolam versus Propofol for Procedural Sedation in the Emergency Department: A Systematic Review

Hohl

Sadatsafavi²,

Nosyk³

et al. 2008

Academic Emergency Medicine

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The use of propofol for procedural sedation in emergency departments

Wakai

Blackburn

McCabe

et al. 2015

Cochrane Database of Systematic Reviews

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No firm conclusions can be drawn concerning the comparative effects of administering intravenous propofol, with or without an adjunctive analgesic agent, with alternative interventions in participants undergoing PS in the ED setting on adverse effects (including pain at the injection site) and participant satisfaction. The review was limited because no two included studies employed the same comparator interventions, and because the number of participants in eight of the included studies were small (fewer than 100 participants).

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Anaesthetic and sedative agents used for electrical cardioversion

Lewis

Nicholson

Reed

et al. 2015

Cochrane Database of Systematic Reviews

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Age Effect on Efficacy and Side Effects of Two Sedation and Analgesia Protocols on Patients Going through Cardioversion: A Randomized Clinical Trial

Abstract: Background: Cardioversion (CV), a painful procedure, requires sedation and analgesia. Although several sedation agents currently are in use for CV, data on age-specific efficacy and side effects of midazolam and propofol have been limited.

Cited by 31 publications

References 29 publications

Safety and Clinical Effectiveness of Midazolam versus Propofol for Procedural Sedation in the Emergency Department: A Systematic Review

Safety and Clinical Effectiveness of Midazolam versus Propofol for Procedural Sedation in the Emergency Department: A Systematic Review

The use of propofol for procedural sedation in emergency departments

Anaesthetic and sedative agents used for electrical cardioversion

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