Remifentanil versus Propofol/Fentanyl Combination in Procedural Sedation for Dislocated Shoulder Reduction; a Clinical Trial.
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|contributor author||Monsef Kasmaee V|
|contributor author||Zia Zibari SM|
|contributor author||Aghajani Nargesi M.|
|description abstract||INTRODUCTION:Procedural�sedation�and analgesia (PSA) is a fundamental skill for every emergency physician. This study aimed to compare the PSA characteristics of�remifentanil�with�propofol/fentanyl�combination.METHODS:In this double-blind randomized�clinical�trial, the�procedural�characteristics and number of failures, as well as adverse events were compared between groups treated with either�remifentanil�or�propofol/fentanyl�combination�consisting of 15-60 year old patients referring to emergency department following acute anterior�shoulder�dislocation.RESULTS:64 patients were randomly assigned to either�remifentanil�(32 cases) or�propofol/fentanyl, (32 cases) groups. The two groups were similar regarding mean age, sex, and pain severity at the time of presentation to ED. The two regimens had the same efficiency regarding pain management (100% success rate). 22 (68.8%) cases in�remifentanil�group and 4 (12.5%) cases in�propofol/fentanyl�group had failed in muscle relaxation (p < 0.001). In the group receiving�remifentanil, onset of action (p = 0.043) and recovery time (p < 0.001) were significantly shorter. 10 (31.3%) cases in�remifentanil�group and 11 (34.4%) cases in the other group experienced adverse events (p =0.790). There was a significant difference between groups regarding the type of adverse events (p = 0.003).CONCLUSION:Compared to�propofol/fentanyl�combination,�remifentanil�has equal efficiency in pain management, lower success rate in muscle relaxation, significantly higher frequency of apnea, and shorter onset of action and recovery times in PSA for�reduction�of anterior�shoulder�dislocation.|
|title||Remifentanil versus Propofol/Fentanyl Combination in Procedural Sedation for Dislocated Shoulder Reduction; a Clinical Trial.|
|journal title||Arch Acad Emerg Med|