Randomized Clinical Trial of Etomidate Versus Propofol for Procedural Sedation in the Emergency Department

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

“…In addition, whenever SRD was reported in the PS literature, it was considered to be a mild and expected AE of PS of unclear clinical significance. 2,15,[20][21][22][23][24] Data Analysis AEs. We found significant variation in the definitions and reporting of minor AEs, so that these results could not be pooled into meaningful summary statistics.…”

“…A sensitivity analysis was performed to assess the impact of individual studies and low-quality studies on the results of the meta-analysis. This was done by removing one RCT at a time from the Bag-mask valve ventilation Death < 93% 4 Use of an oral airway Disability < 92% 2,20 Transient apnea Hospital admission < 90% 3,5,6,12,15,[22][23][24]29,33,34,[40][41][42][43] Vomiting without aspiration Prolonged ED stay Transient hypotension Intubation Myoclonus…”

“…1,3,4 Ketamine, etomidate, ketafol, and methohexital are used less commonly in adults, and ketamine and etomidate are associated with minor yet bothersome side effects (emergence and myoclonus, respectively), which may limit their widespread use in this patient population. 2,[5][6][7][8][9] Cohort studies, registry data, and small randomized controlled trials (RCTs) suggest that propofol and midazolam are safe and effective for use in PS. However, only few comparative studies have been conducted, and it remains unclear whether one agent is superior with regard to safety and clinical effectiveness endpoints.…”

“…The ideal sedative agent for PS has a rapid onset of action and a limited duration of action, can be combined with a short-acting narcotic, and is associated with few major adverse events (AEs). 1,2 Several sedative agents are currently used for PS in adults. 1 At present, the choice of agent depends largely on local practice patterns and practitioner comfort.…”

Comparision of Etomidate versus Propofol for Anaesthesia in Short Case Surgical Procedures

“…11 It is already reported that etomidate is associated with significantly less pain on injection than propofol added lidocain in children. 12 The only negative characteristic noted with etomidate was high incidence of myoclonic jerks. Miner et al 13 was also concluded high incidence of myoclonus (20% vs. Propofol has anti-emetic properties and studies have shown a lower incidence of postoperative nausea and vomiting (PONV) in patients receiving propofol as induction agent and more frequent nausea and vomiting during and after anesthesia in patients who received etomidate.…”