Comparison of Sedatives for the Reduction of Shoulder Dislocation Based on Bispectral Index System in Emergency Department: A Randomized, Three-Group, Double-Blinded Clinical Trial

Publish Year: 1401
نوع سند: مقاله ژورنالی
زبان: English
View: 98

This Paper With 10 Page And PDF Format Ready To Download

  • Certificate
  • من نویسنده این مقاله هستم

استخراج به نرم افزارهای پژوهشی:

لینک ثابت به این Paper:

شناسه ملی سند علمی:

JR_ZUMS-30-142_003

تاریخ نمایه سازی: 23 مهر 1401

Abstract:

Background and Objective: Procedural sedation and analgesia (PSA) includes the administration of sedative/dissociative medications with or without the concomitant delivery of analgesic agents. The bispectral index system (BIS) is a modern technology for neurophysiological monitoring that continuously analyzes the patient’s electroencephalogram curve during sedation to assess the level of consciousness. This study aimed to compare various PSA protocols, including propofol/fentanyl, propofol/ketamine, and ketamine, based on the BIS and other critical items in adults with anterior shoulder dislocation (ASD) in the emergency department. Materials and Methods: This randomized three-group double-blinded clinical trial was conducted on ۱۵۰ patients with ASD in Besat General Hospital in Tehran, Iran. The sample size was determined at ۵۰ individuals in each group receiving propofol/fentanyl (group A), propofol/ketamine (ketofol; group B), and ketamine (group C). Before PSA, the sensor of the BIS monitor was attached to the patient, and several items were compared, including the side effects and duration of sedation, as well as BIS values before and ۱-۵ min after PSA. Results: Visual analogue scale scores before and after the intervention were obtained at ۸.۱±۰.۶۹ and ۲.۰۸±۰.۷, respectively. The BIS values at the ۱st, ۲nd, ۳rd, ۴th, and ۵th min after PSA were not different in the three groups. The comparison between the three groups regarding the patients’ satisfaction showed that there was a significant difference between them (P=۰.۰۲), which was higher in the ketofol group. Conclusion: The investigation of PSA using propofol/ketamine, ketamine, and propofol/fentanyl showed similar frequencies of BIS values and adverse respiratory events. The use of propofol/fentanyl was associated with a slightly higher incidence of hypotension. Moreover, the frequency of patient satisfaction was higher among the subjects in group B, compared to those in the other groups.

Keywords:

Bispectral index system , Fentanyl , Ketamine , Procedural sedation and analgesia , Propofol

Authors

Maryam Massaeli

Dept. of Emergency Medicine, AJA University of Medical Sciences, Tehran, Iran

Soheil Nasouhi

Dept. of Emergency Medicine, AJA University of Medical Sciences, Tehran, Iran

Hoshang Bahrani

Dept. of Anesthesiology, AJA University of Medical Sciences, Tehran, Iran

Heydar Hosseinnejad

Dept. of Anesthesiology, Islamic Azad University, Shahrood Branch, Shahrood, Iran

Ehsan Akrami

Dept. of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Afshin Motallebzadeh

Dept. of Cardiac Surgery, Razavi Hospital, Mashhad, Iran

Maedeh Baniasadi

Faculty of Nursing and Midwifery, Islamic Azad University, Karaj Branch, Karaj, Iran

Masoud Shahabian

Dept. of Emergency Medicine, AJA University of Medical Sciences, Tehran, Iran

مراجع و منابع این Paper:

لیست زیر مراجع و منابع استفاده شده در این Paper را نمایش می دهد. این مراجع به صورت کاملا ماشینی و بر اساس هوش مصنوعی استخراج شده اند و لذا ممکن است دارای اشکالاتی باشند که به مرور زمان دقت استخراج این محتوا افزایش می یابد. مراجعی که مقالات مربوط به آنها در سیویلیکا نمایه شده و پیدا شده اند، به خود Paper لینک شده اند :
  • Godwin SA, Burton JH, Gerardo CJ, et al. Clinical policy: ...
  • Tezel O, Kaldirim U, Bilgic S, et al. A comparison ...
  • Khalili GR, Sajedi P, Afshari ZF. Depth of anesthesia determination ...
  • Orlinsky M, Shon S, Chiang C, Chan L, Carter P. ...
  • Frazee BW, Park RS, Lowery D, Baire M. Propofol for ...
  • Miner JR, Moore JC, Austad EJ, Plummer D, Hubbard L, ...
  • Payas A, Kaygusuz K, Düger C, et al. The effects ...
  • Gan TJ, Glass PS, Windsor A, et al. Bispectral index ...
  • Miner JR, Burton JH. Clinical practice advisory: Emergency department procedural ...
  • Bowdle TA, Radant AD, Cowley DS, Kharasch ED, Strassman RJ, ...
  • Akin A, Guler G, Esmaoglu A, Bedirli N, Boyaci A. ...
  • Akin A, Esmaoglu A, Guler G, Demircioglu R, Narin N, ...
  • Sener S, Eken C, Schultz CH, Serinken M, Ozsarac M. ...
  • Khajavi M, Emami A, Etezadi F, Safari S, Sharifi A, ...
  • Ferguson I, Bell A, Treston G, New L, Ding M, ...
  • Andolfatto G, Abu-Laban RB, Zed PJ, et al. Ketamine-propofol combination ...
  • Hug CC, McLeskey CH, Nahrwold ML, et al. Hemodynamic effects ...
  • Claeys MA, Gepts E, Camu F. Haemodynamic changes during anaesthesia ...
  • Kim G, Green SM, Denmark TK, Krauss B. Ventilatory response ...
  • Green SM, Andolfatto G, Krauss B. Ketofol for procedural sedation? ...
  • Mourad M, El-Hamamsy M, Anwar M, Schwartz E. Low dose ...
  • Gan TJ, Glass PS, Windsor A,et al. Bispectral index monitoring ...
  • David H, Shipp J. A randomized controlled trial of ketamine/propofol ...
  • Burns SM. Delirium during emergence from anesthesia: a case study. ...
  • Tomoda K, Shingu K, Osawa M, Murakawa M, Mori K. ...
  • Wathen JE, Roback MG, Mackenzie T, Bothner JP. Does midazolam ...
  • Sener S, Eken C, Schultz CH, Serinken M, Ozsarac M. ...
  • Strayer RJ, Nelson LS. Adverse events associated with ketamine for ...
  • Horwitz LI, Green J, Bradley EH. US emergency department performance ...
  • Yatim F. Intravenous ketamine is as effective as midazolam/fentanyl for ...
  • Pradhan RL, Lakhey S, Pandey BK, Rijal KP. Reduction of ...
  • Leffert RD, Seddon H. Infraclavicular brachial plexus injuries. J Bone ...
  • نمایش کامل مراجع