Sedative Effect of Etomidate and Fentanyl by the Combinational Administration During Closed Thoracostomy

ABSTRACT

PURPOSE: As a sedative hypnotic agent, etomidate has a little side effect like respiratory depression and has an excellent pharmacokinetics and hemodynamics. The objective of this study is comparison of etomidate effect in the two groups, only lidocaine injection group and combinational administration group, during closed thoracostomy in the emergency department. METHODS: The patients with respiratory problems, which needed a closed thoracostomy, from March 1, 2003 to February 29, 2004 were enrolled in this prospective study. Thus, we were enrolled 68 patients. etomidate were used for 34 patients and only lidocaine local injection was used for 34 patients. Patients of combinational administration were randomized to receive intravenous boluses of etomidate (0.2 mg/kg) prior to fentanyl (1.0 ug/kg) during PSA (procedural sedation anesthesia). We recorded pre-administration and interval of 5 minute, 10 minute, 15 minute and transcutaneous oxygen saturation, heart rate, respiratory rate, blood pressure, degree of sedation, satisfaction of sedation, and side effects after administration. RESULTS: Of all combinational administration group, significant hemodynamic, as hypotension or bradycardia etc. and respiratory depression, as apnea or tachypnea etc. were absent. With comparison of two groups, significant clinical problems and statistics were not different and degree of sedation was fast and impaired conscious was effective in the combinational administration group. CONCLUSION: We conclude combinational administration with etomidate and fentanyl during procedural sedation is safty and excellent effectiveness. Therefore we recommened the use of etomidate for emergency procedural sedation in emergency department.