Amini Afshin, Arhami Dolatabadi Ali, Kariman Hamid, Hatamabadi Hamidreza, Memary Elham, Salimi Sohrab, Shokrzadeh Shahram
Emerg (Tehran). 2018;6(1):e57. Epub 2018 Oct 2.
Need for procedural sedation and analgesia (PSA) is felt in emergency department (ED) more and more each day. This study aimed to compare the effectiveness of low-dose fentanyl, propofol, midazolam, ketamine and lidocaine combination with regular dose of propofol and fentanyl combination for induction of deep sedation.
In this single-blind clinical trial, candidate patients for sedation and analgesia aged more than 15 and less than 60 years old, with pain score ≥6 were allocated to one of the groups using block randomization and were compared regarding onset of action, recovery time, and probable side effects.
125 patients with the mean age of 37.8 ± 14.3 years were randomly allocated to each group. 100% of the patients in group 1 (5 drugs) and 56.5% of the patients in group 2 (2 drugs) were deeply sedated in the 3 minute after injection. The 2 groups were significantly different regarding onset of action (p = 0.440), recovery time (p = 0.018), and treatment failure (p < 0.001).
Low-dose fentanyl, propofol, midazolam, ketamine and lidocaine combination was more successful in induction of deep sedation compared to regular dose of propofol and fentanyl combination. Recovery time was a little longer in this group and both groups were similar regarding drug side effects and effect on vital signs.
急诊室（ED）对程序性镇静和镇痛（PSA）的需求日益增加。本研究旨在比较低剂量芬太尼、丙泊酚、咪达唑仑、氯胺酮和利多卡因联合用药与常规剂量丙泊酚和芬太尼联合用药诱导深度镇静的效果。
在这项单盲临床试验中，年龄在15岁以上、60岁以下、疼痛评分≥6分的镇静和镇痛候选患者采用区组随机化方法分配到其中一组，并比较起效时间、恢复时间和可能的副作用。
平均年龄为37.8±14.3岁的125例患者被随机分配到每组。注射后3分钟内，第1组（5种药物）100%的患者和第2组（2种药物）56.5%的患者达到深度镇静。两组在起效时间（p = 0.440）、恢复时间（p = 0.018）和治疗失败率（p < 0.001）方面存在显著差异。
与常规剂量的丙泊酚和芬太尼联合用药相比，低剂量芬太尼、丙泊酚、咪达唑仑、氯胺酮和利多卡因联合用药诱导深度镇静更成功。该组恢复时间稍长，两组在药物副作用和对生命体征的影响方面相似。
