Etomidate for procedural sedation in the emergency department

Pharmacotherapy. 2002 May;22(5):586-92. doi: 10.1592/phco.22.8.586.33204.

Abstract

Study objective: To review our experience with etomidate in nonintubated patients in the emergency department.

Design: A 2-year retrospective chart review of consecutive patients receiving etomidate for sedation.

Setting: Emergency department of a university-based teaching hospital.

Patients: Forty-eight patients who underwent painful procedures in the emergency department.

Measurements and main results: Demographics, dosing information, recovery times, and adverse events were abstracted using a standardized data collection form. Forty-eight nonintubated patients were sedated with etomidate. Mean age was 34 years (range 6-80 yrs); 38 were men and 10 women; two were children. The mean initial dose of etomidate was 13 mg. Adverse events occurred in 11 (21%) patients. None sustained any substantial morbidity as indicated by need for intubation, prolonged emergency department stay, or hospital admission.

Conclusion: Although controversial, etomidate holds promise as a potent sedative agent for patients undergoing painful procedures in the emergency department. A large prospective evaluation is needed to document the performance and complications of this agent.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Conscious Sedation*
  • Emergency Medical Services / methods*
  • Etomidate* / administration & dosage
  • Etomidate* / adverse effects
  • Female
  • Humans
  • Hypnotics and Sedatives* / administration & dosage
  • Hypnotics and Sedatives* / adverse effects
  • Male
  • Middle Aged
  • Pain
  • Retrospective Studies

Substances

  • Hypnotics and Sedatives
  • Etomidate