Propofol Versus Midazolam for Procedural Sedation of Anterior Shoulder Dislocation in Emergency Department: A Randomized Clinical Trial

Hatamabadi, Hamid Reza; Arhami Dolatabadi, Ali; Derakhshanfar, Hojjat; Younesian, Somaye; Ghaffari Shad, Ensieh

doi:10.5812/traumamon.13530

Propofol Versus Midazolam for Procedural Sedation of Anterior Shoulder Dislocation in Emergency Department: A Randomized Clinical Trial

Authors

Hamid Reza Hatamabadi

Ali Arhami Dolatabadi

Hojjat Derakhshanfar

Somaye Younesian

Ensieh Ghaffari Shad

10.5812/traumamon.13530

Abstract

Background: Anterior shoulder dislocation (ASD) is one of the most common reasons for referrals to emergency departments (ED). Usually, a combination of an intravenous narcotic and a benzodiazepine is used for procedural sedation and analgesia (PSA) in such cases. Objectives: This study compares the efficacy of two combinations to reduce ASD. Patients and Methods: The subjects in this clinical trial consisted of 48 patients with ASD who were randomly assigned to midazolam/fentanyl and propofol/fentanyl groups for PSA. The two groups were compared to the time interval between injection and induction of sedation (T1), duration of time from sedation to awakening (T2), the duration of time between sedation and full awareness to time, location and individuals (T3), and possible side effects. Results: Twenty-nine subjects (60.4%) were sedated with midazolam and 19 (39.6%) were sedated with propofol. During the procedure, one patient in the propofol group experienced apnea (P = 0.39) and three patients (one in the midazolam group and two in the propofol group) experienced bradycardia (P = 0.34). The mean T1, T2, and T3 were significantly shorter in the propofol group (P < 0.001). Conclusions: It seems that propofol and fentanyl can be used as a safe and fast combination for PSA in the reduction of ASD.

Keywords

Propofol

Midazolam

Shoulder dislocation

Sedation

Analgesic