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https://hdl.handle.net/11499/6166
Title: | Ketamine with and without midazolam for emergency department sedation in adults: A randomized controlled trial | Authors: | Sener, S. Eken, C. Schultz, C.H. Serinken, Mustafa Ozsarac, M. |
Keywords: | ketamine midazolam placebo adult analgesia anesthetic recovery apnea article combination chemotherapy double blind procedure emergency ward female hallucination human larynx spasm major clinical study male monotherapy nausea nightmare pain patient satisfaction priority journal randomized controlled trial recovery agitation respiratory tract disease sedation vomiting |
Publisher: | Mosby Inc. | Abstract: | Study objective We assess whether midazolam reduces recovery agitation after ketamine administration in adult emergency department (ED) patients and also compared the incidence of adverse events (recovery agitation, respiratory, and nausea/vomiting) by the intravenous (IV) versus intramuscular (IM) route. Methods This prospective, double-blind, placebo-controlled, 2×2 factorial trial randomized consecutive ED patients aged 18 to 50 years to 4 groups: receiving either 0.03 mg/kg IV midazolam or placebo, and with ketamine administered either 1.5 mg/kg IV or 4 mg/kg IM. Adverse events and sedation characteristics were recorded. Results Of the 182 subjects, recovery agitation was less common in the midazolam cohorts (8% versus 25%; difference 17%; 95% confidence interval [CI] 6% to 28%; number needed to treat 6). When IV versus IM routes were compared, the incidences of adverse events were similar (recovery agitation 13% versus 17%, difference 4%, 95% CI 8% to 16%; respiratory events 0% versus 0%, difference 0%, 95% CI 2% to 2%; nausea/vomiting 28% versus 34%, difference 6%, 95% CI 8% to 20%). Conclusion Coadministered midazolam significantly reduces the incidence of recovery agitation after ketamine procedural sedation and analgesia in ED adults (number needed to treat 6). Adverse events occur at similar frequency by the IV or IM routes. © 2010 American College of Emergency Physicians. | URI: | https://hdl.handle.net/11499/6166 https://doi.org/10.1016/j.annemergmed.2010.09.010 |
ISSN: | 0196-0644 |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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