ABSTRACT
STUDY OBJECTIVE: To determine the efficacy and safety of methohexital sodium (MTX) in emergency department patients. DESIGN: A consecutive case series; all ED patients who received MTX from July 1989 through July 1990 were studied in a prospective manner. SETTING: A university hospital ED. PARTICIPANTS: All 102 adult and pediatric patients who received MTX. INTERVENTIONS: Emergency physicians trained in the use of MTX administered the drug. A study form was completed that provided data on dosage and response, indications for use, final diagnosis, hemodynamic and respiratory parameters, and an efficacy survey. RESULTS: Average cumulative dose of MTX was 1.6 +/- 1.3 mg/kg. The average duration of action per dose was 7.6 +/- 5.0 minutes. Leading indications for use were orthopedic procedures (54), endotracheal intubation (18), head computed tomography scan (ten), and wound care (eight). Hemodynamic changes were minimal; the average change in systolic blood pressure five minutes after MTX was -1.8 +/- 20 mm Hg. Average heart rate change was 3.0 +/- 20 beats. Percent respiratory depression was 17 +/- 24%. There was no correlation between MTX dose and the degree of respiratory depression. Narcotics and/or benzodiazepines were given with MTX in 92 cases, with no significant increase in respiratory depression. No major complications attributable to MTX were identified. CONCLUSION: MTX, when used by trained personnel who adhere to an established protocol, appears to be a safe and effective drug in selected ED patients.