Abstract
STUDY OBJECTIVE
To compare the efficacy of diazepam and midazolam when used for conscious sedation in emergency department patients.
DESIGN
Prospective, randomized, double-blind, multicenter trial.
SETTING
Three university EDs.
TYPE OF PARTICIPANTS
Patients requiring one of the following procedures: abscess drainage, joint reduction, extensive suturing, chest tube insertion, or lumbar puncture.
INTERVENTIONS
Diazepam (2.5 mg/mL) or midazolam (1 mg/mL) was administered until the desired level of sedation was achieved to a maximum of 5 mL. Fentanyl citrate was administered if needed for pain.
MEASUREMENTS AND MAIN RESULTS
Thirty-three patients received diazepam and 36 received midazolam. Patients receiving midazolam had a greater degree of early sedation (P < .05), a higher 90-minute alertness scale score (P < .05), more patients ready for discharge at 90 minutes (P = .05), significantly less recall for the procedure (P < .02), and less pain on injection (P < .01) than patients who were given diazepam.
CONCLUSIONS
Diazepam and midazolam are both effective for conscious sedation in ED patients. Midazolam causes less pain on injection, a significantly greater degree of early sedation, and a more rapid return to baseline function.
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