Annals of emergency medicine
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Randomized Controlled Trial Comparative Study
A randomized controlled trial comparing patient-controlled and physician-controlled sedation in the emergency department.
We compare patient-controlled sedation (PCS) and emergency physician-controlled sedation (EPCS) with respect to propofol requirements, depth of sedation, adverse events, recovery time, physician satisfaction, and patient satisfaction in emergency department (ED) patients requiring brief but painful procedures. ⋯ Compared with EPCS, PCS demonstrated similar propofol dosing, safety, recovery, and satisfaction but resulted in lighter sedation. Propofol PCS appears safe and effective for ED procedures requiring moderate rather than deep sedation.
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To identify the minimum clinically significant difference in pain in elderly emergency department (ED) patients. ⋯ The arithmetic minimum clinically significant difference in older ED patients was 1.5 NRS units and decreased over time, whereas the proportional change was 25% and more stable.
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Randomized Controlled Trial Comparative Study
Sufentanil is not superior to morphine for the treatment of acute traumatic pain in an emergency setting: a randomized, double-blind, out-of-hospital trial.
We determine the best intravenous opioid titration protocol by comparing morphine and sufentanil for adult patients with severe traumatic acute pain in an out-of-hospital setting, with a physician providing care. ⋯ Intravenous morphine titration using a loading dose of morphine followed by strictly administered lower doses at regular intervals remains the criterion standard. Moreover, this study supports the idea that the doses studied should be considered for routine administration in severe pain protocols.