Abstract
Objective
Many procedures performed in emergency department are stressful and painful, and creating
proper and timely analgesia and early and effective assessment are the challenges
in this department. This study has been conducted in order to compare the efficacy
of propofol and fentanyl combination with propofol and ketamine combination for procedural
sedation and analgesia (PSA) in trauma patients in the emergency department.
Method
This is a randomized prospective double-blind clinical trial conducted in the emergency
department of Imam Khomeini Hospital, a tertiary academic trauma center in northern
Iran. Patients with trauma presenting to the emergency department who needed PSA were
included in study. Patients were divided into two groups of propofol fentanyl (PF)
and propofol ketamine (PK). Pain score and sedation depth were set as primary outcome
measures and were recorded.
Results
Out of about 379 patients with trauma, who needed PSA, 253 met the criteria to be
included in the study, 117 of which were excluded. The remaining 136 patients were
randomly allocated to either PF group (n = 70) or PK group (n = 66). Pain management
after drug administration was significantly different between the groups and the analgesia
caused by fentanyl was significantly higher than ketamine. The sedation score after
15 min of PSA in the group PF was significantly higher than the group PK.
Conclusion
It seems that regarding PSA in the emergency department, PF caused better analgesia
and deeper sedation and it is recommended to use PF for PSA in the emergency departments.
Keywords
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Article Info
Publication History
Published online: February 02, 2018
Accepted:
January 25,
2018
Received in revised form:
January 24,
2018
Received:
September 30,
2017
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.