HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wyer, P. C Search for Related Content PubMed PubMed Citation Articles by Wyer, P. C

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

Clinical impact ratings Emergency medicine Paediatrics (general)

Key Words: analgesics (non-narcotic) • etomidate • fractures (closed) • hypnotics and sedatives • manipulation (orthopaedic) • midazolam • pain

The first 150 words of the full text of this article appear below.

METHODS
Design: randomised controlled trial.

Allocation: concealed.^*

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

Follow up period: up to discharge.

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

Patients: 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, pregnancy, allergy to study drugs, consumption of solids <6 hours or liquids <2 hours previously, and inability to obtain intravenous (IV) access.

Intervention: etomidate, 0.2 mg/kg (maximum 10 mg) (n = 50) or midazolam, 0.1 mg/kg (maximum 5 mg) (n = 50) administered in a slow IV push. Fentanyl was administered for analgesia to both groups in titrated doses to a maximum of 2 . . . [Full text of this article]

Peter C Wyer, MD, FACEP

Columbia University,
New York City, New York, USA