Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4)
Latest & greatest articles for sedation
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on sedation or other clinical topics then use Trip today.
This page lists the very latest high quality evidence on sedation and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.
What is Trip?
Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.
Trip has been online since 1997 and in that time has developed into the internet’s premier source of evidence-based content. Our motto is ‘Find evidence fast’ and this is something we aim to deliver for every single search.
As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news.
For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via email@example.com
Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. Gamma-aminobutyric acid receptor agonist medications are the most commonly used sedatives for intensive care unit (ICU) patients, yet preliminary evidence indicates that the alpha(2) agonist dexmedetomidine may have distinct advantages.To compare the efficacy and safety of prolonged sedation with dexmedetomidine vs midazolam for mechanically ventilated patients.Prospective, double-blind, randomized trial (...) conducted in 68 centers in 5 countries between March 2005 and August 2007 among 375 medical/surgical ICU patients with expected mechanical ventilation for more than 24 hours. Sedation level and delirium were assessed using the Richmond Agitation-Sedation Scale (RASS) and the Confusion Assessment Method for the ICU.Dexmedetomidine (0.2-1.4 microg/kg per hour [n = 244]) or midazolam (0.02-0.1 mg/kg per hour [n = 122]) titrated to achieve light sedation (RASS scores between -2 and +1) from enrollment until
Subdissociative-dose ketamine versus fentanyl for analgesia during propofol procedural sedation: a randomized clinical trial The authors sought to compare the safety and efficacy of subdissociative-dose ketamine versus fentanyl as adjunct analgesics for emergency department (ED) procedural sedation and analgesia (PSA) with propofol.This double-blind, randomized trial enrolled American Society of Anesthesiology (ASA) Class I or II ED patients, aged 14-65 years, requiring PSA for orthopedic (...) reduction or abscess drainage. Subjects received 0.3 mg/kg ketamine or 1.5 mug/kg fentanyl intravenously (IV), followed by IV propofol titrated to deep sedation. Supplemental oxygen was not routinely administered. The primary outcomes were the frequency and severity of cardiorespiratory events and interventions, rated using a composite intrasedation event rating scale. Secondary outcomes included the frequency of specific scale component events, propofol doses required to achieve and maintain sedation
Palliative sedation. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding for the National Guideline Clearinghouse (NGC) has ended. Learn more
Does the time of fasting affect complication rates during ketamine sedation BestBets: Does the time of fasting affect complication rates during ketamine sedation Does the time of fasting affect complication rates during ketamine sedation Report By: Ray McGlone - Consultant in Emergency Medicine Search checked by Simon Carley - Consultant in Emergency Medicine Institution: Lancaster Royal Infirmary Original author: Ray McGlone Original institution: Lancaster Royal Infirmary Current web editor (...) : Tom Bartram - middle grade A+E Date Submitted: 4th March 2005 Last Modified: 14th August 2008 Status: Green (complete) Three Part Question [In children undergoing ketamine sedation] is [prolonged fasting (6 hours or more) better than short term fasting (3 hours)] at [reducing the incidence of vomiting and other complications of sedation] Clinical Scenario A 4 year old boy is brought to the emergency department having fallen over at home. He has sustained a 3 cm deep laceration to the forehead. He
A randomized trial of daily awakening in critically ill patients managed with a sedation protocol: a pilot trial Protocolized sedation (PS) and daily sedative interruption (DI) in critically ill patients have both been shown to shorten the durations of mechanical ventilation (MV) and intensive care unit (ICU) stay. Our objective was to determine the safety and feasibility of a randomized trial to determine whether adults managed with both PS + DI have a shorter duration of MV than patients (...) managed with PS alone.Prospective randomized, concealed, unblinded, multicenter, pilot trial.Three university-affiliated medical-surgical ICUs.Sixty-five adults anticipated to require MV >48 hrs and receiving sedative/analgesic infusions.Patients were randomized to PS alone, or PS + DI. PS was implemented by bedside nurses; sedatives/analgesics were titrated to achieve Sedation Agitation Score (SAS) 3-4. The PS + DI group also had infusions interrupted daily until the patients awoke.Diagnosis, age
Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Comparison of the effect of protocol-directed sedation with propofol vs. midazolam by nurses in intensive care: efficacy, haemodynamic stability and patient satisfaction The aim of this study was to compare the effect of protocol-directed sedation propofol vs. midazolam by nurses in intensive care on efficacy, haemodynamic stability and patient satisfaction.Protocols represent one method potentially to reduce treatment delays and ensure that medical care is administered in a standardised manner (...) . Propofol and midazolam are often used for sedation in intensive care units.A randomised, prospective cohort study and data were collected in 2003. The subjects were randomised either into propofol (n = 32) or into midazolam (n = 28) group. Efficacy of sedation, haemodynamic stability, pulse oximetry saturation, Acute Physiology and Chronic Health Evaluation II (APACHE II score), weaning time from mechanical ventilation, duration of mechanical ventilation, length of stay at intensive care unit, sedative
A cost-effectiveness analysis of propofol versus midazolam for procedural sedation in the emergency department To determine the incremental cost-effectiveness of using propofol versus midazolam for procedural sedation (PS) in adults in the emergency department (ED).The authors conducted a cost-effectiveness analysis from the perspective of the health care provider. The primary outcome was the incremental cost (or savings) to achieve one additional successful sedation with propofol compared (...) . A standard meta-analytic technique was used to calculate the weighted mean difference in recovery times and obtain mean drug doses from patient-level data from a randomized controlled trial. Probabilistic sensitivity analyses were conducted to examine the uncertainty around the estimated incremental cost-effectiveness ratio using Monte Carlo simulation.Choosing a sedation strategy with propofol resulted in average savings of $17.33 (95% confidence interval [CI] = $24.13 to $10.44) per sedation performed
Intra-articular block compared with conscious sedation for closed reduction of ankle fracture-dislocations. A prospective randomized trial Ankle fracture-dislocations require urgent reduction to protect the soft tissues, to minimize articular injury, and to allow swelling to decrease. Conscious sedation is commonly used to provide analgesia for closed reduction of this injury. We hypothesized that an intra-articular block of the ankle would provide similar analgesia and the ability to reduce (...) the ankle with a lower risk than conscious sedation.Between September 2005 and January 2007, forty-two patients with an ankle fracture-dislocation presented to our emergency department and were enrolled in a prospective randomized study. The patients were given either conscious sedation or an intra-articular lidocaine block for the reduction and for the application of a plaster splint. After the reduction maneuver, the patients used a visual analog pain scale to rate the level of pain before, during
Continuous deep sedation for patients nearing death in the Netherlands: descriptive study. To study the practice of continuous deep sedation in 2005 in the Netherlands and compare it with findings from 2001.Questionnaire study about random samples of deaths reported to a central death registry in 2005 and 2001.Nationwide physician study in the Netherlands.Reporting physicians received a questionnaire about the medical decisions that preceded the patient's death; 78% (n=6860) responded in 2005 (...) and 74% (n=5617) in 2001.Characteristics of continuous deep sedation (attending physician, types of patients, drugs used, duration, estimated effect on shortening life, palliative consultation). Requests for euthanasia.The use of continuous deep sedation increased from 5.6% (95% confidence interval 5.0% to 6.2%) of deaths in 2001 to 7.1% (6.5% to 7.6%) in 2005, mostly in patients treated by general practitioners and in those with cancer (in 2005, 47% of sedated patients had cancer v 33% in 2001
Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Approaches to removal of sedation and mechanical ventilation for critically ill patients vary widely. Our aim was to assess a protocol that paired spontaneous awakening trials (SATs)-ie, daily interruption of sedatives-with spontaneous breathing trials (SBTs).In four tertiary-care hospitals, we (...) randomly assigned 336 mechanically ventilated patients in intensive care to management with a daily SAT followed by an SBT (intervention group; n=168) or with sedation per usual care plus a daily SBT (control group; n=168). The primary endpoint was time breathing without assistance. Data were analysed by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00097630.One patient in the intervention group did not begin their assigned treatment protocol because of withdrawal
2008LancetControlled trial quality: predicted high
The use of propofol for medium and long-term sedation in critically ill adult patients: a meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Adverse events associated with ketamine for procedural sedation in adults Adverse events associated with ketamine for procedural sedation in adults Adverse events associated with ketamine for procedural sedation in adults Strayer RJ, Nelson LS CRD summary The review concluded that when ketamine was used for procedural sedation in adults, cardiorespiratory adverse events were rare but dysphoric emergence phenomena occurred in 10% to 20% patients and there was a likelihood of airway obstruction (...) . The reliability of the authors’ conclusions is uncertain due to review process limitations and uncertain quality and design of the many included studies. Authors' objectives To evaluate the safety of the use of ketamine for procedural sedation in adults. Searching PubMed, EMBASE, TOXNET (to May 2006) and The Cochrane Library were searched for publications in English, Spanish, Russian, French, Portuguese and German; search terms were reported. Australian Adverse Drug Reactions Bulletin, European Public
A systematic review and meta-analysis of randomized, controlled trials of moderate sedation for routine endoscopic procedures Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Short-acting agents for procedural sedation and analgesia in Canadian emergency departments: a review of clinical outcomes and economic evaluation Short-acting agents for procedural sedation and analgesia in Canadian emergency departments: a review of clinical outcomes and economic evaluation Short-acting agents for procedural sedation and analgesia in Canadian emergency departments: a review of clinical outcomes and economic evaluation Bond K, Fassbender K, Karkhaneh M, Spooner C, Horton J (...) , Sivilotti MLA, Campbell SG, Vandermeer B, Tjosvold L, Seal R, Rowe BH Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Bond K, Fassbender K, Karkhaneh M, Spooner C, Horton J, Sivilotti MLA, Campbell SG, Vandermeer B, Tjosvold L, Seal R, Rowe BH. Short-acting agents for procedural sedation and analgesia in Canadian emergency departments: a review
A randomized trial of protocol-directed sedation management for mechanical ventilation in an Australian intensive care unit To compare protocol-directed sedation management with traditional non-protocol-directed practice in mechanically ventilated patients.Randomized, controlled trial.General intensive care unit (24 beds) in an Australian metropolitan teaching hospital.Adult, mechanically ventilated patients (n = 312).Patients were randomly assigned to receive sedation directed by formal (...) , estimated that protocol sedation management was associated with a 22% decrease (95% confidence interval 40% decrease to 2% increase, p = .07) in the occurrence of successful weaning from mechanical ventilation.This randomized trial provided no evidence of a substantial reduction in the duration of mechanical ventilation or length of stay, in either the intensive care unit or the hospital, with the use of protocol-directed sedation compared with usual local management. Qualified high-intensity nurse
Midazolam or ketamine for procedural sedation of children in the emergency department BestBets: Midazolam or ketamine for procedural sedation of children in the emergency department Midazolam or ketamine for procedural sedation of children in the emergency department Report By: Andrew Munro - Specialist in Emergency Medicine FACEM Search checked by Ian Machonochie - Consultant in Paediatric Emergency Medicine Institution: Coffs Harbour Base Hospital, NSW, Australia Date Submitted: 28th May 2003 (...) Date Completed: 27th July 2007 Last Modified: 18th June 2007 Status: Green (complete) Three Part Question In [children needing painful procedures in the emergency department] is [ midazolam or ketamine] [ safer and more effective at achieving conscious sedation]? Clinical Scenario A mother brings her five year old son to the Emergency Department (ED) with a deep scalp laceration having fallen onto the corner of a coffee table. The wound requires sutures. For various reasons the option
Routine follow-up visits not necessary after third molar removal under sedation. This was a randomised controlled trial (RCT) conducted in the US.People were recruited to the trial who required surgical removal of at least two impacted third molars under intravenous sedation on an outpatient basis. They were treated by board-certified oral and maxillofacial surgeons. Participants were divided randomly into two groups: the first was given a 2-week postoperative follow-up appointment (...) ).A routine follow-up visit following third molar removal under intravenous sedation is not necessary in patients aged between 15 and 35 years. Pre-operative and postoperative instructions should be clear, however. A selective review policy may be appropriate if a patient is mentally retarded, is taking psychoactive drugs, or has an intra-operative complications or a has made a complaint via telephone.
Low-dose ketamine in addition to propofol for procedural sedation and analgesia in the emergency department Low-dose ketamine in addition to propofol for procedural sedation and analgesia in the emergency department Low-dose ketamine in addition to propofol for procedural sedation and analgesia in the emergency department Loh G, Dalen D CRD summary This review concluded that there is insufficient evidence to recommend the routine use of low-dose ketamine combined with propofol for procedural (...) sedation in the emergency department setting. Although the review has a number of weaknesses, this conclusion is appropriate. Authors' objectives To evaluate the safety and efficacy of low-dose intravenous ketamine with intravenous propofol for sedation and analgesia during emergency department procedures. Searching MEDLINE, EMBASE, BioMed Central, the Cochrane Library, International Pharmaceutical Abstracts and Google Scholar were searched from inception to February 2007; key search terms were