Etomidate and midazolam for procedural sedation: prospective, randomized trial

To evaluate whether there is a difference in the time of sedation and time to patient disposition in patients undergoing procedural sedation with etomidate and midazolam.

Prospective, randomized, double-blind trial comparing etomidate (0.10 mg/kg) and midazolam (0.035 mg/kg) for patients requiring procedural sedation for reduction of joint dislocations or long bone fractures.

Forty-five patients were enrolled (24 randomized to etomidate, 21 to midazolam). Groups were similar in demographics and analgesic dosing. Mean time of sedation for etomidate was 15 minutes (SD, 10.97) and for midazolam was 32 minutes (SD, 16.13) (P<.001). Mean time to disposition for etomidate was 121 minutes (SD, 73.28) and for midazolam was 111 minutes (SD, 96.36) (P=.700). The mean quality of sedation for etomidate was 7.91 (SD, 1.53) and for midazolam was 7.48 (SD, 2.89) (P=.570).

The use of etomidate compared with midazolam for procedural sedation provides a significant reduction in recovery time, without a reduction in time to patient disposition, while providing equal sedation quality.