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Archives of Disease in Childhood - Education and Practice 2008;93:72
Copyright © 2008 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health

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EVIDENCE-BASED MEDICINE

Etomidate had shorter induction and recovery times than midazolam for fracture reduction


In children and adolescents presenting with a displaced extremity fracture who require sedation, does etomidate show faster onset and recovery than midazolam?

Keywords: analgesics (non-narcotic); etomidate; fractures (closed); hypnotics and sedatives; manipulation (orthopaedic); midazolam; pain

The first 150 words of the full text of this article appear below.

Di Liddo L, D'Angelo A, Nguyen B, et al. Etomidate versus midazolam for procedural sedation in pediatric outpatients: a randomized controlled trial. Ann Emerg Med 2006;48:433â40.

Clinical impact ratings Emergency medicine âââââââ Paediatrics (general) âââââââ


METHODS
Formula Design: randomised controlled trial.

Formula Allocation: concealed.*

Formula Blinding: blinded (patients, investigators, {data collectors, outcome assessors, and data analysts}{dagger}).*

Formula Follow up period: up to discharge.

Formula Setting: emergency department (ED) of a tertiary care paediatric hospital.

Formula Patients: 100 patients 2–18 years of age (mean age 8.7 y, 50% boys) who presented to the ED with a displaced extremity fracture requiring sedation and analgesia for closed reduction. Exclusion criteria included respiratory tract infection, haemodynamic instability, recent head injury, known seizure disorder, heart or lung disease, craniofacial anomaly, adrenocortical dysfunction, pregnancy, allergy to study drugs, consumption of solids <6 hours or liquids <2 hours previously, and inability to obtain intravenous (IV) access.

Formula Intervention: etomidate, 0.2 mg/kg . . . [Full text of this article]

Peter C Wyer

Columbia University, New York City, New York, USA







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