Open AccessMidazolam, Etomidate, Propofol, Fentanyl, Ketamine, and Propofol/Ketamine for Procedural Sedation and Analgesia Among Adults in the Emergency Departments: A Systematic Review
Author(s) -
Maryam Massaeli,
Soheil Nasouhi,
Afshin Motallebzadeh,
Masoud Shahabian
Publication year - 2020
Publication title -
shiraz e medical journal.
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.195
H-Index - 10
ISSN - 1735-1391
DOI - 10.5812/semj.96024
Subject(s) - etomidate , ketamine , propofol , medicine , midazolam , fentanyl , sedation , anesthesia , dexmedetomidine , adverse effect , randomized controlled trial , medline , clinical trial , surgery , pharmacology , political science , law
: The current systematic review aimed at investigating different medications commonly used for procedural sedation and analgesia (PSA) in emergency departments (EDs) for adults. The articles related to the subject of interest were searched in five electronic databases, including Google Scholar, PubMed, Medline, Web of Science, Scopus, and Embase, up to 2019. The blinded, randomized, controlled, clinical trials comparing common PSA medications, including midazolam, etomidate, propofol, fentanyl, ketamine, and ketofol, among the adults undergoing PSA in EDs were included in the study. The search process resulted in the inclusion of 35 papers in the study. The main information, including clinical features, sedation duration, recovery time, and incidence of adverse events, was extracted from the selected studies. Based on the reviewed studies, various combinations of medications are used for PSA depending on the hospital protocols and policies; however, there is still controversy over the best choice. As the results of the retrieved articles indicated, propofol is the most common medication used for PSA in EDs due to the shorter time of induction, rapid recovery of consciousness, and fewer side effects. Etomidate and ketamine were also identified as other common sedatives applied for PSA.