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Conference Paper: IV droperidol or olanzapine as adjuncts to midazolam for the acutely agitated patient: a multi-centre, randomised, double-blind, placebo-controlled, clinical trial

TitleIV droperidol or olanzapine as adjuncts to midazolam for the acutely agitated patient: a multi-centre, randomised, double-blind, placebo-controlled, clinical trial
Authors
Issue Date2012
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1742-6723
Citation
The 28th Annual Scientific Meeting of the Australasian College for Emergency Medicine (ACEM 2011), Sydney, Australia, 20-24 November 2011. In Emergency Medicine Australasia, 2012, v. 24 suppl. s1, p. 18 How to Cite?
AbstractOBJECTIVES: To determine if IV droperidol or olanzapine, as adjuncts to midazolam administration, improve sedation quality for the acutely agitated ED patient METHODS: We undertook a randomised, double-blind, placebocontrolled, double-dummy, clinical trial in three EDs (August 2009 to March 2011). Adult patients requiring IV drug sedation for acute agitation were enrolled. Each was randomised to receive an IV bolus of either saline (control), droperidol (5 mg) or olanzapine (5 mg). This bolus was immediately followed by an IV midazolam bolus (2.5–5 mg) then additional boluses until sedation to a predetermined endpoint was achieved. The primary outcome was time to sedation. Secondary outcomes were the need for ‘rescue’ sedation and adverse events. RESULTS: 336 patients were enrolled. The baseline characteristics of the groups did not differ (p > 0.05). However, the median (IQR) times to sedation (min) differed signifi cantly (p < 0.001): control group 10 (4–25), droperidol 6 (3–10), olanzapine 5 (3–10). At any time point, patients in the droperidol and olanzapine groups were ∼1.6 times more likely to be sedated compared to controls: droperidol and olanzapine group hazard ratios (95%CI) were 1.58 (1.21–2.06) and 1.64 (1.25–2.15), respectively, (p = 0.001). The droperidol and olanzapine groups required less rescue sedation and alternative drug use at any time after initial sedation had been achieved (p < 0.05). The group adverse event profi les and lengths of stay did not differ (p = 0.21 and 0.32, respectively). CONCLUSION: Droperidol or olanzapine administration, as adjuncts to midazolam, is safe and signifi cantly improves sedation quality. These fi ndings will inform best-practice for sedation of the acutely agitated ED patient.
DescriptionOral Programme Abstratcs
This FREE journal suppl. entitled: Special Issue: Abstracts of the 28th Annual Scientific Meeting of the Australasian College for Emergency Medicine, 20-24 November 2011, Sydney, Australia
Persistent Identifierhttp://hdl.handle.net/10722/195553
ISSN
2015 Impact Factor: 1.223
2015 SCImago Journal Rankings: 0.567

 

DC FieldValueLanguage
dc.contributor.authorTaylor, DM-
dc.contributor.authorChan, EWY-
dc.contributor.authorKong, DCM-
dc.contributor.authorKnott, JC-
dc.contributor.authorPhillips, GA-
dc.contributor.authorCastle, DJ-
dc.date.accessioned2014-03-04T06:36:23Z-
dc.date.available2014-03-04T06:36:23Z-
dc.date.issued2012-
dc.identifier.citationThe 28th Annual Scientific Meeting of the Australasian College for Emergency Medicine (ACEM 2011), Sydney, Australia, 20-24 November 2011. In Emergency Medicine Australasia, 2012, v. 24 suppl. s1, p. 18-
dc.identifier.issn1742-6731-
dc.identifier.urihttp://hdl.handle.net/10722/195553-
dc.descriptionOral Programme Abstratcs-
dc.descriptionThis FREE journal suppl. entitled: Special Issue: Abstracts of the 28th Annual Scientific Meeting of the Australasian College for Emergency Medicine, 20-24 November 2011, Sydney, Australia-
dc.description.abstractOBJECTIVES: To determine if IV droperidol or olanzapine, as adjuncts to midazolam administration, improve sedation quality for the acutely agitated ED patient METHODS: We undertook a randomised, double-blind, placebocontrolled, double-dummy, clinical trial in three EDs (August 2009 to March 2011). Adult patients requiring IV drug sedation for acute agitation were enrolled. Each was randomised to receive an IV bolus of either saline (control), droperidol (5 mg) or olanzapine (5 mg). This bolus was immediately followed by an IV midazolam bolus (2.5–5 mg) then additional boluses until sedation to a predetermined endpoint was achieved. The primary outcome was time to sedation. Secondary outcomes were the need for ‘rescue’ sedation and adverse events. RESULTS: 336 patients were enrolled. The baseline characteristics of the groups did not differ (p > 0.05). However, the median (IQR) times to sedation (min) differed signifi cantly (p < 0.001): control group 10 (4–25), droperidol 6 (3–10), olanzapine 5 (3–10). At any time point, patients in the droperidol and olanzapine groups were ∼1.6 times more likely to be sedated compared to controls: droperidol and olanzapine group hazard ratios (95%CI) were 1.58 (1.21–2.06) and 1.64 (1.25–2.15), respectively, (p = 0.001). The droperidol and olanzapine groups required less rescue sedation and alternative drug use at any time after initial sedation had been achieved (p < 0.05). The group adverse event profi les and lengths of stay did not differ (p = 0.21 and 0.32, respectively). CONCLUSION: Droperidol or olanzapine administration, as adjuncts to midazolam, is safe and signifi cantly improves sedation quality. These fi ndings will inform best-practice for sedation of the acutely agitated ED patient.-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1742-6723-
dc.relation.ispartofEmergency Medicine Australasia-
dc.titleIV droperidol or olanzapine as adjuncts to midazolam for the acutely agitated patient: a multi-centre, randomised, double-blind, placebo-controlled, clinical trialen_US
dc.typeConference_Paperen_US
dc.identifier.emailChan, EWY: ewchan@hku.hk-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1111/j.1742-6723.2012.01520.x-
dc.identifier.hkuros213755-
dc.identifier.volume24-
dc.identifier.issuesuppl. s1-
dc.identifier.spage18-
dc.identifier.epage18-
dc.publisher.placeAustralia-
dc.customcontrol.immutablesml 160629 amended-

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