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依托咪酯和咪达唑仑用于操作过程中的镇静:前瞻性随机试验。

Etomidate and midazolam for procedural sedation: prospective, randomized trial.

作者信息

Hunt Gregory S, Spencer Matthew T, Hays Daniel P

机构信息

Department of Emergency Medicine, St. Luke's Hospital, New Bedford, MA 02740, USA.

出版信息

Am J Emerg Med. 2005 May;23(3):299-303. doi: 10.1016/j.ajem.2005.02.042.

Abstract

OBJECTIVE

To evaluate whether there is a difference in the time of sedation and time to patient disposition in patients undergoing procedural sedation with etomidate and midazolam.

METHODS

Prospective, randomized, double-blind trial comparing etomidate (0.10 mg/kg) and midazolam (0.035 mg/kg) for patients requiring procedural sedation for reduction of joint dislocations or long bone fractures.

RESULTS

Forty-five patients were enrolled (24 randomized to etomidate, 21 to midazolam). Groups were similar in demographics and analgesic dosing. Mean time of sedation for etomidate was 15 minutes (SD, 10.97) and for midazolam was 32 minutes (SD, 16.13) (P<.001). Mean time to disposition for etomidate was 121 minutes (SD, 73.28) and for midazolam was 111 minutes (SD, 96.36) (P=.700). The mean quality of sedation for etomidate was 7.91 (SD, 1.53) and for midazolam was 7.48 (SD, 2.89) (P=.570).

CONCLUSIONS

The use of etomidate compared with midazolam for procedural sedation provides a significant reduction in recovery time, without a reduction in time to patient disposition, while providing equal sedation quality.

摘要

目的

评估在接受依托咪酯和咪达唑仑程序镇静的患者中,镇静时间和患者处置时间是否存在差异。

方法

前瞻性、随机、双盲试验,比较依托咪酯(0.10mg/kg)和咪达唑仑(0.035mg/kg)用于因关节脱位或长骨骨折复位而需要程序镇静的患者。

结果

纳入45例患者(24例随机接受依托咪酯,21例接受咪达唑仑)。两组在人口统计学和镇痛剂量方面相似。依托咪酯的平均镇静时间为15分钟(标准差,10.97),咪达唑仑为32分钟(标准差,16.13)(P<0.001)。依托咪酯的平均处置时间为121分钟(标准差,73.28),咪达唑仑为111分钟(标准差,96.36)(P=0.700)。依托咪酯的平均镇静质量为7.91(标准差,1.53),咪达唑仑为7.48(标准差,2.89)(P=0.570)。

结论

与咪达唑仑相比,使用依托咪酯进行程序镇静可显著缩短恢复时间,在不减少患者处置时间的同时,提供同等的镇静质量。

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