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

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

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

Embedded ImageDesign:

randomised controlled trial.

Embedded ImageAllocation:

concealed.*

Embedded ImageBlinding:

blinded (patients, investigators, {data collectors, outcome assessors, and data analysts}†).*

Embedded ImageFollow up period:

up to discharge.

Embedded ImageSetting:

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

Embedded ImagePatients:

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, …

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Footnotes

  • Source of funding: Fonds d’opération pour les projects de recherche de l’Hôpital Ste-Justine.

  • Reproduced with permission from Evidence-Based Medicine 2007;12:77

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