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Etomidate for procedural sedation in the emergency department
Samuel M Keim1, Brian L Erstad, John C Sakles
1Department of Emergency Medicine, Arizona Health Sciences Center, Tucson, USA. sam@aemrc.arizona.edu
Pharmacotherapy
|May 16, 2002
Summary
Etomidate is a promising sedative for nonintubated patients undergoing painful procedures in the emergency department. While adverse events occurred, no patients experienced severe complications, warranting further investigation.
Area of Science:
- Emergency Medicine
- Pharmacology
- Sedation
Background:
- Etomidate is an anesthetic agent with sedative properties.
- Its use in nonintubated emergency department patients for procedural sedation is not well-established.
- Controversy exists regarding its safety profile in this population.
Purpose of the Study:
- To review the experience with etomidate for procedural sedation in nonintubated emergency department patients.
- To evaluate the efficacy and safety of etomidate in this setting.
Main Methods:
- Retrospective chart review of 48 consecutive nonintubated patients receiving etomidate for painful procedures.
- Data collected included demographics, dosing, recovery times, and adverse events.
- Study conducted at a university-based teaching hospital's emergency department.
Main Results:
- The mean age of patients was 34 years, with 79% being male.
- The mean initial dose of etomidate was 13 mg.
- Adverse events occurred in 21% of patients, but none resulted in intubation, prolonged ED stay, or hospital admission.
Conclusions:
- Etomidate shows potential as a potent sedative for painful procedures in nonintubated emergency department patients.
- Despite some adverse events, significant morbidity was not observed.
- Further large-scale prospective studies are required to fully establish its performance and safety profile.