Ketamine With and Without Midazolam for Emergency Department Sedation in Adults: A Randomized Controlled Trial

Şener, Serkan; Eken, Cenker; Schultz, Carl H.; Serinken, Mustafa; Ozsarac, Murat

doi:10.1016/j.annemergmed.2010.09.010

Cited by 131 publications

(80 citation statements)

References 15 publications

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“…The mean dose of ketamine in our study probably represents a mix of different uses and reflects the practise variability between physicians. Intra-nasal use of ketamine, which was only recently recognised as an alternative, was not reported in our study patients, but it is likely to be used in the near future [20,22,23].…”

Section: Analgesic Strategiesmentioning

confidence: 94%

Pain Management Strategies and Time Spent on Scene for Pre-Hospital Analgesia Provision in an Alpine Environment: A Retrospective Study

Pasquier¹,

Eidenbenz²,

Dami³

et al. 2017

Emerg Med

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Objective: The delivery of a safe an effective analgesia is a core principle and a priority of prehospital care. Analgesia in hostile environments (mountain settings, etc.) presents various challenges, and the benefit-risk ratio of the procedure should be evaluated. The objective of this study was to examine pain management strategies and the time spent on scene for analgesia provisions in an alpine environment. Methods:We undertook a retrospective study from a single physician-staffed helicopter emergency medical service in the Swiss Alps. Patients with isolated limb injuries were included. We examined the choice and route of analgesic medication, patient monitoring, medical co-treatments and time delays during the rescue mission.Results: Analgesia was provided to 657 (57%) of the 1156 included patients. Fentanyl was most commonly administered followed by ketamine, with or without fentanyl. Heart rhythm monitoring, oxygen administration, and saline infusion were used infrequently, but were used significantly more often in patients treated with ketamine. The median time on site was 6 minutes longer for patients receiving intravenous analgesia compared with those not receiving it.Conclusion: Analgesia in hostile environments seems to be limited to essential procedures. The safety of this approach must be confirmed.

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Section: Analgesic Strategiesmentioning

confidence: 94%

Pain Management Strategies and Time Spent on Scene for Pre-Hospital Analgesia Provision in an Alpine Environment: A Retrospective Study

Pasquier¹,

Eidenbenz²,

Dami³

et al. 2017

Emerg Med

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“…Therefore, the follow-up time used in the present study could be considered enough to see the most side effects. Pharmacol 2017;12: 180-185Based on previous evidence, the usual side effects such as nausea and vomiting was reported in a range between 3.6 and 29% for the midazolam-ketamine group, and in the range of 1.8 to 7% for the fentanylmidazolam group (Roback et al, 2005;Sener et al, 2011;Wathen et al, 2000). In current research, nausea and vomiting was observed in 12.1% of participants in the midazolam-ketamine group and 5% of the participants in the fentanyl-midazolam group, which is less than those reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Fentanyl-midazolam vs. midazolam-ketamine regarding patient sedation analgesia for emergency orthopedic procedures

Abdolrazaghnejad

Banaie

2017

Bangladesh J Pharmacol

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<p class="Abstract">The aim of the present study was to investigate two pharmaceutical groups including fentanyl-midazolam and midazolam-ketamine used as patient seda-tion analgesia for the orthopedic emergency procedures. This is a prospective randomized double-blind and placebo-controlled trial study. Trauma patients admitted to emergency department who needed emergency reduction were enrolled. Finally 81 patients with mean age of 31.7 ± 20.6 years old were participated (64.2% male). It is likely that the combination of midazolam-ketamine had a better performance in terms of the duration of hypoxia (p=0.01), and pain scores during reduction (p=0.001). However, adverse effects were higher in the midazolam-ketamine group compared to the fentanyl-midazolam. The level of satisfaction of physicians and patients were the same.</p>

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“…Procedural sedation is a technique of administering sedatives (midazolam, propofol) or dissociative agents (ketamine) with or without opioid analgesics (fentanyl, morphine) to induce a state that allows the patient to tolerate unpleasant procedures while maintaining cardiorespiratory function (5). Ketamine hydrochloride is usually used as a sedation agent in the emergency department.…”

Section: Discussionmentioning

confidence: 99%

Total Rectal Prolapse Reduced via Ketamine Administration in the Emergency Department

Kesim¹,

Acar²,

Arziman³

et al. 2012

JAEMCR

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Total rectal prolapse (procidencia) is a clinical state in which all layers of the rectum protrude through the anal canal. The etiology is not completely understood. It is an uncommon situation and patients must be diagnosed early; cases should be reduced manually in the emergency department until ischemia occurs in order to decrease complications. Some additional techniques have been presented in the literature in cases of failure using manual reduction. Procedural sedation and analgesia procedure can improve patient comfort and the success rate of manual reduction alone or in addition to these techniques. In this case report, we present a total rectal prolapse reduced after procedural sedation via intravenous ketamine administration in the emergency department.Keywords: Rectal prolapse, ketamine, emergency service Received: 04.12.2011 Accepted: 09.01.2012 ÖZET Total rektal prolapsus (prosidensia) rektumun bütün katlarının anal kanaldan sarktığı klinik durumdur. Etyolojisi tam olarak anlaşılamamıştır. Nadir bir durumdur ve komplikasyonları azaltmak için hastalara acil serviste erken tanı konmalı ve prolapsus iskemi oluşmadan önce elle redükte edilmelidir. Elle redüksiyonun başa-rılamadığı durumlar için literatürde bazı teknikler tanımlanmıştır. Prosedürel sedasyon ve analjezi işlemi, hastanın konforunu ve elle redüksiyon başarı oranını tek başına veya bu tekniklere ek olarak kullanıldığı zaman artırabilir. Bu yazıda acil serviste intravenöz ketamin ile prosedürel sedasyon sonrası redükte edilen total rektal prolapsus olgusunu sunduk.

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Ketamine With and Without Midazolam for Emergency Department Sedation in Adults: A Randomized Controlled Trial

Cited by 131 publications

References 15 publications

Pain Management Strategies and Time Spent on Scene for Pre-Hospital Analgesia Provision in an Alpine Environment: A Retrospective Study

Pain Management Strategies and Time Spent on Scene for Pre-Hospital Analgesia Provision in an Alpine Environment: A Retrospective Study

Fentanyl-midazolam vs. midazolam-ketamine regarding patient sedation analgesia for emergency orthopedic procedures

Total Rectal Prolapse Reduced via Ketamine Administration in the Emergency Department

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