Use of Propofol Saves Time Compared to Midazolam/Ketamine

Procedural sedation with propofol expedites patient management in emergency departments

FRIDAY, Dec. 30 (HealthDay News) -- Procedural sedation with propofol accelerates patient management in emergency departments, and saves time in comparison with midazolam/ketamine sedation, according to a study published in the Dec. 21 issue of The Journal of Bone & Joint Surgery.

Ofir Uri, M.D., from the Tel Aviv Sourasky Medical Center in Israel, and colleagues compared the recovery time, total sedation time, and adverse events seen with use of procedural sedation and analgesia induced with propofol versus midazolam/ketamine. A total of 60 adults (mean age, 45 years) undergoing orthopedic manipulations in the emergency department were randomized to receive propofol or midazolam/ketamine (30 participants in each regimen). Trained and approved orthopedic residents, assisted by registered nurses, gave the sedations and performed the orthopedic manipulations. Real-time records of adverse events and sedation times were recorded.

The investigators found that the average recovery time after sedation differed significantly between the groups (7.8 ± 3.7 minutes in the propofol group versus 30.7 ± 10.1 minutes in the midazolam/ketamine group). The average total sedation time also differed significantly between the groups (16.2 ± 3.8 minutes in the propofol group versus 41.6 ± 10.7 minutes in the midazolam/ketamine group). The overall rates of respiratory and hemodynamic adverse events were 20 and 10 percent in the propofol and midazolam/ketamine groups, respectively.

"The use of propofol for an orthopedic procedure requiring sedation in the emergency department expedites patient management and saves time in comparison with the use of midazolam/ketamine," the authors write.

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