Y F Choi1, T W Wong, C C Lau. 1. Accident and Emergency Department, Pamela Youde Nethersole Eastern Hospital, 3, Lok Man Road, Hong Kong SAR. choiyf@netvigator.com
Abstract
OBJECTIVE: To compare the haemodynamic effect of low dose midazolam and etomidate as induction agent in emergency department rapid sequence intubation. METHODS: A prospective observational study in two phases. In phase one, midazolam 2-4 mg was used as induction agent and in phase two, etomidate 0.2-0.3 mg/kg was used. The haemodynamic data were recorded before and after intubation for comparison. Changes in mean systolic blood pressure were analysed with SPSS software. RESULTS: A 10% decrease in mean systolic blood pressure was observed in the midazolam group (p = 0.001) while there was no significant change in the etomidate group. Some 19.5% of patients had hypotension after being given midazolam while only 3.6% with etomidate (p = 0.002). Patients older than 70 tended to have more hypotension episodes but the difference was not statistically significant. CONCLUSIONS: Midazolam, even in low dose, was more likely than etomidate to cause significant hypotension when used as an induction agent for rapid sequence intubation. Etomidate is a better alternative.
OBJECTIVE: To compare the haemodynamic effect of low dose midazolam and etomidate as induction agent in emergency department rapid sequence intubation. METHODS: A prospective observational study in two phases. In phase one, midazolam 2-4 mg was used as induction agent and in phase two, etomidate 0.2-0.3 mg/kg was used. The haemodynamic data were recorded before and after intubation for comparison. Changes in mean systolic blood pressure were analysed with SPSS software. RESULTS: A 10% decrease in mean systolic blood pressure was observed in the midazolam group (p = 0.001) while there was no significant change in the etomidate group. Some 19.5% of patients had hypotension after being given midazolam while only 3.6% with etomidate (p = 0.002). Patients older than 70 tended to have more hypotension episodes but the difference was not statistically significant. CONCLUSIONS:Midazolam, even in low dose, was more likely than etomidate to cause significant hypotension when used as an induction agent for rapid sequence intubation. Etomidate is a better alternative.
Authors: Stephen J Halliday; Jonathan D Casey; Todd W Rice; Matthew W Semler; David R Janz; Derek W Russell; James Dargin; Derek J Vonderhaar; Jason R West; Matthew M Churpek Journal: Ann Am Thorac Soc Date: 2020-08
Authors: Stephen Su Yang; Charles Gelinas; Edmund Yim; Mandy M J Li; Kenneth Kardash; Michelle Zhang; Jed Lipes Journal: Can J Anaesth Date: 2022-10-12 Impact factor: 6.713
Authors: Kohei Hasegawa; Yusuke Hagiwara; Taichi Imamura; Takuyo Chiba; Hiroko Watase; Calvin A Brown; David Fm Brown Journal: Int J Emerg Med Date: 2013-04-24