OBJECTIVES To systematically review the literature comparing the efficacy and safety of dexmedetomidine and midazolam when used for procedural sedation. MATERIALS AND METHODS We searched MEDLINE, EMBASE and COCHRANE for clinical trials comparing dexmedetomidine and midazolam for procedural sedation up to June 20, 2016. Inclusion criteria: clinical trial, human subjects, adult subjects (≥18 ye...

We present an evidence-based clinical practice guideline for the administration of the dissociative agent ketamine for emergency department pediatric procedural sedation and analgesia. Substantial research in recent years has necessitated updates and revisions to the widely disseminated 1990 recommendations. We critically discuss indications, contraindications, personnel requirements, monitorin...

Propofol is a sedative agent gaining popularity for Emergency Department Procedural Sedation (EDPS). However, some institutions across the country continue to restrict the use of propofol secondary to safety concerns. The purpose of our study was to evaluate the complication rate of EDPS with propofol. We conducted a prospective, observational, multi-center study of EDPS patients aged > or = 18...

All healthcare professionals involved in the administration of sedation and participating assessment, monitoring recovery children requiring procedural analgesia (PSA) are accountable for safe practice. The child is entitled to same standard care, whether procedure undertaken outside hospital (primary care), a physician’s office, dental surgery, remote facility or an operating theatre. new guid...

Results The response rate was 81% (n=17). Of these, 71% (n=12) “often” or “sometimes” use physical restrain of children during procedures. Paediatric sedation is only possible in 29% of the EDs (n= 5). 29% (n=5) of the leading nurses stated that they at least once a month found there is a need for procedural sedation that their department is unable to provide. The three most commonly mentioned ...

BACKGROUND To safely perform acute intra-arterial revascularization procedures, use of sedative medications and paralytics is often necessary. During the conduct of the Interventional Management of Stroke trials (I and II), the level of sedation used periprocedurally varied. At some institutions, patients were paralyzed and intubated as part of the procedural standard of care while at other ins...

PURPOSE To compare the effectiveness of 2 medication regimens, propofol/fentanyl (P/F) and ketamine/midazolam (K/M), for brief orthopedic emergency department procedural sedation. This study was powered to compare recovery times (RT) and procedural distress as measured by the Observational Score of Behavioral Distress-revised (OSBD-r; range: 0-23.5 with 23.5 representing maximal distress). ME...

STUDY OBJECTIVE Midazolam is widely used for procedural sedation and analgesia. Etomidate has been studied mostly in adults. Our objective is to compare the efficacy of etomidate and midazolam for achieving procedural sedation and analgesia in children. METHODS A randomized, double-blind, emergency department and orthopedic clinic-based trial was carried out among patients aged 2 to 18 years ...