دوره 30، شماره 142 - ( 7-1401 )                   جلد 30 شماره 142 صفحات 416-407 | برگشت به فهرست نسخه ها

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Massaeli M, Nasouhi S, Bahrani H, Hosseinnejad H, Akrami E, Motallebzadeh A, et al . Comparison of Sedatives for the Reduction of Shoulder Dislocation Based on Bispectral Index System in Emergency Department: A Randomized, Three-Group, Double-Blinded Clinical Trial. J Adv Med Biomed Res 2022; 30 (142) :407-416
URL: http://journal.zums.ac.ir/article-1-6578-fa.html
Comparison of Sedatives for the Reduction of Shoulder Dislocation Based on Bispectral Index System in Emergency Department: A Randomized, Three-Group, Double-Blinded Clinical Trial. Journal of Advances in Medical and Biomedical Research. 1401; 30 (142) :407-416

URL: http://journal.zums.ac.ir/article-1-6578-fa.html

Comparison of Sedatives for the Reduction of Shoulder Dislocation Based on Bispectral Index System in Emergency Department: A Randomized, Three-Group, Double-Blinded Clinical Trial
چکیده:   (47817 مشاهده)

Background and Objective: Procedural sedation and analgesia (PSA) includes the administration of sedative/dissociative medications with or without the concomitant delivery of analgesic agents. The bispectral index system (BIS) is a modern technology for neurophysiological monitoring that continuously analyzes the patient’s electroencephalogram curve during sedation to assess the level of consciousness. This study aimed to compare various PSA protocols, including propofol/fentanyl, propofol/ketamine, and ketamine, based on the BIS and other critical items in adults with anterior shoulder dislocation (ASD) in the emergency department.
Materials and Methods: This randomized three-group double-blinded clinical trial was conducted on 150 patients with ASD in Besat General Hospital in Tehran, Iran. The sample size was determined at 50 individuals in each group receiving propofol/fentanyl (group A), propofol/ketamine (ketofol; group B), and ketamine (group C). Before PSA, the sensor of the BIS monitor was attached to the patient, and several items were compared, including the side effects and duration of sedation, as well as BIS values before and 1-5 min after PSA.
Results: Visual analogue scale scores before and after the intervention were obtained at 8.1±0.69 and 2.08±0.7, respectively. The BIS values at the 1st, 2nd, 3rd, 4th, and 5th min after PSA were not different in the three groups. The comparison between the three groups regarding the patients’ satisfaction showed that there was a significant difference between them (P=0.02), which was higher in the ketofol group.
Conclusion: The investigation of PSA using propofol/ketamine, ketamine, and propofol/fentanyl showed similar frequencies of BIS values and adverse respiratory events. The use of propofol/fentanyl was associated with a slightly higher incidence of hypotension. Moreover, the frequency of patient satisfaction was higher among the subjects in group B, compared to those in the other groups.

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نوع مطالعه: کارآزمایی بالینی | موضوع مقاله: Clinical medicine
دریافت: 1400/3/19 | پذیرش: 1401/4/16 | انتشار: 1401/5/17
فهرست منابع
1. Godwin SA, Burton JH, Gerardo CJ, et al. Clinical policy: procedural sedation and analgesia in the emergency department. Ann Emerg Med. 2014;63(2):247-58.e18. [DOI:10.1016/j.annemergmed.2013.10.015] [PMID]
2. Tezel O, Kaldirim U, Bilgic S, et al. A comparison of suprascapular nerve block and procedural sedation analgesia in shoulder dislocation reduction. Am J Emerg Med. 2014;32(6):549-52. [DOI:10.1016/j.ajem.2014.02.014] [PMID]
3. Khalili GR, Sajedi P, Afshari ZF. Depth of anesthesia determination by using bispectral index in patients underwent inhalation or total intravenous general anesthesia. J Isfahan Med Sch. 2007; 25(86):70-8.
4. Orlinsky M, Shon S, Chiang C, Chan L, Carter P. Comparative study of intra-articular lidocaine and intravenous meperidine/diazepam for shoulder dislocations. J Emerg Med. 2002;22(3):241-5. [DOI:10.1016/S0736-4679(01)00475-9]
5. Frazee BW, Park RS, Lowery D, Baire M. Propofol for deep procedural sedation in the ED. Am J Emerg Med. 2005;23(2):190-5. [DOI:10.1016/j.ajem.2004.05.008] [PMID]
6. Miner JR, Moore JC, Austad EJ, Plummer D, Hubbard L, Gray RO. Randomized, double-blinded, clinical trial of propofol, 1: 1 propofol/ketamine, and 4: 1 propofol/ketamine for deep procedural sedation in the emergency department. Ann Emerg Med. 2015;65(5):479-88. e2. [DOI:10.1016/j.annemergmed.2014.08.046] [PMID]
7. Payas A, Kaygusuz K, Düger C, et al. The effects of bispectral index and neuromuscular blockade monitoring on the depth of anaesthesia and recovery in cardiac patients under desflurane anaesthesia. Turkish J Anaesthesiol Reanimat. 2013;41(6):211-5. [DOI:10.5152/TJAR.2013.48] [PMID] [PMCID]
8. Gan TJ, Glass PS, Windsor A, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS utility study group. Anesthesiology. 1997;87(4):808-15. [DOI:10.1097/00000542-199710000-00014] [PMID]
9. Miner JR, Burton JH. Clinical practice advisory: Emergency department procedural sedation with propofol. Ann Emerg Med. 2007;50(2):182-7, 7.e1. [DOI:10.1016/j.annemergmed.2006.12.017] [PMID]
10. Bowdle TA, Radant AD, Cowley DS, Kharasch ED, Strassman RJ, Roy-Byrne PP. Psychedelic effects of ketamine in healthy volunteers: relationship to steady-state plasma concentrations. Anesthesiology. 1998;88(1):82-8. [DOI:10.1097/00000542-199801000-00015] [PMID]
11. Akin A, Guler G, Esmaoglu A, Bedirli N, Boyaci A. A comparison of fentanyl-propofol with a ketamine-propofol combination for sedation during endometrial biopsy. J Clin Anesth. 2005;17(3):187-90. [DOI:10.1016/j.jclinane.2004.06.019] [PMID]
12. Akin A, Esmaoglu A, Guler G, Demircioglu R, Narin N, Boyaci A. Propofol and propofol-ketamine in pediatric patients undergoing cardiac catheterization. Pediatr Cardiol. 2005;26(5):553-7. [DOI:10.1007/s00246-004-0707-4] [PMID]
13. Sener S, Eken C, Schultz CH, Serinken M, Ozsarac M. Ketamine with and without midazolam for emergency department sedation in adults: a randomized controlled trial. Ann Emerg Med. 2011;57(2):109-14. e2. [DOI:10.1016/j.annemergmed.2010.09.010] [PMID]
14. Khajavi M, Emami A, Etezadi F, Safari S, Sharifi A, Shariat Moharari R. Conscious sedation and analgesia in colonoscopy: Ketamine/propofol combination has superior patient satisfaction versus fentanyl/propofol. Anesthesiol Pain Med. 2013;3(1):208-13. [DOI:10.5812/aapm.9653] [PMID] [PMCID]
15. Ferguson I, Bell A, Treston G, New L, Ding M, Holdgate A. Propofol or ketofol for procedural sedation and analgesia in emergency medicine-the POKER study: a randomized double-blind clinical trial. Ann Emerg Med. 2016;68(5):574-82. e1. [DOI:10.1016/j.annemergmed.2016.05.024] [PMID]
16. Andolfatto G, Abu-Laban RB, Zed PJ, et al. Ketamine-propofol combination (ketofol) versus propofol alone for emergency department procedural sedation and analgesia: a randomized double-blind trial. Ann Emerg Med. 2012;59(6):504-12. e2. [DOI:10.1016/j.annemergmed.2012.01.017] [PMID]
17. Hug CC, McLeskey CH, Nahrwold ML, et al. Hemodynamic effects of propofol: data from over 25,000 patients. Anesth Analg. 1993;77(4 Suppl):S21-9.
18. Claeys MA, Gepts E, Camu F. Haemodynamic changes during anaesthesia induced and maintained with propofol. Br J Anaesth. 1988;60(1):3-9. [DOI:10.1093/bja/60.1.3] [PMID]
19. Kim G, Green SM, Denmark TK, Krauss B. Ventilatory response during dissociative sedation in children-a pilot study. Acad Emerg. 2003;10(2):140-5. [DOI:10.1197/aemj.10.2.140]
20. Green SM, Andolfatto G, Krauss B. Ketofol for procedural sedation? Pro and con. Ann Emerg Med. 2011;57(5):444-8. [DOI:10.1016/j.annemergmed.2010.12.009] [PMID]
21. Mourad M, El-Hamamsy M, Anwar M, Schwartz E. Low dose ketamine reduces sedative doses of propofol during ambulatory transoesophageal echocardiography. Egypt J Anaesth. 2004;20:41-6.
22. Gan TJ, Glass PS, Windsor A,et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. J Am Soc Anesthesiol.1997; 87(4): 808-15. [DOI:10.1097/00000542-199710000-00014] [PMID]
23. David H, Shipp J. A randomized controlled trial of ketamine/propofol versus propofol alone for emergency department procedural sedation. Ann Emerg Med. 2011;57(5):435-41. [DOI:10.1016/j.annemergmed.2010.11.025] [PMID]
24. Burns SM. Delirium during emergence from anesthesia: a case study. Crit Care Nurse. 2003;23(1):66-9. [DOI:10.4037/ccn2003.23.1.66] [PMID]
25. Tomoda K, Shingu K, Osawa M, Murakawa M, Mori K. Comparison of CNS effects of propofol and thiopentone in cats. Br J Anaesth. 1993;71(3):383-7. [DOI:10.1093/bja/71.3.383] [PMID]
26. Wathen JE, Roback MG, Mackenzie T, Bothner JP. Does midazolam alter the clinical effects of intravenous ketamine sedation in children? A double-blind, randomized, controlled, emergency department trial. Ann Emerg Med. 2000;36(6):579-88. [DOI:10.1067/mem.2000.111131] [PMID]
27. Sener S, Eken C, Schultz CH, Serinken M, Ozsarac M. Ketamine with and without midazolam for emergency department sedation in adults: a randomized controlled trial. Ann Emerg Med. 2011;57(2):109-14.e2. [DOI:10.1016/j.annemergmed.2010.09.010] [PMID]
28. Strayer RJ, Nelson LS. Adverse events associated with ketamine for procedural sedation in adults. Am J Emerg Med. 2008;26(9):985-1028. [DOI:10.1016/j.ajem.2007.12.005] [PMID]
29. Horwitz LI, Green J, Bradley EH. US emergency department performance on wait time and length of visit. Ann Emerg Med. 2010;55(2):133-41. [DOI:10.1016/j.annemergmed.2009.07.023] [PMID] [PMCID]
30. Yatim F. Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation and analgesia in the emergency department. Med J Malaysia. 2011;66(3):231.
31. Pradhan RL, Lakhey S, Pandey BK, Rijal KP. Reduction of acute anterior shoulder dislocations: comparing intraarticular lignocaine with intravenous anesthesia. JNMA J Nepal Med Assoc. 2006;45(162):223-7.
32. Leffert RD, Seddon H. Infraclavicular brachial plexus injuries. J Bone Joint Surg Br Volume. 1965;47:9-22. [DOI:10.1302/0301-620X.47B1.9]
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