Antipsychotics accelerate patient sedation, study finds

Certain clinically used drug combinations are faster and more effective in sedating highly aggressive patients in emergency departments.

(Medical Xpress)—A new study is shedding light on the use of sedative drugs in hospitals and has proven certain clinically used drug combinations to be faster and more effective in sedating highly aggressive patients in the emergency department (ED).

In an Australian study detailed in the , researchers from Monash University, Austin Health, Royal Melbourne Hospital and St Vincent's found when  droperidol or olanzapine were used in combination with midazolam, adequate sedation of severely agitated emergency patients was achieved faster and were less likely to require re-sedation.

Investigators Dr David Kong and Dr Esther Chan, from the Centre for Medicine Use and Safety, said although a wide range of drugs and (including droperidol or olanzapine) were used in clinical settings to sedate very agitated patients, the clinical evidence to support the combinations was lacking.

"Agitation and aggression is frequently observed in patients admitted to the emergency department as a result of mental illness, drug and , or both," Dr Kong said.

"We have compared three commonly used in order to evaluate their safety and efficacy for the sedation of acutely agitated patients."

Researchers found antipsychotic drugs droperidol or , in combination with midazolam, shortened the time to sedation by an average of four to five minutes. 

"Our findings provide important evidence about how patients with acute agitation in EDs could be optimally managed by clinicians utilising a combination of medications," Dr Kong said.

"More effective management of acute agitation could significantly reduce stress and maximise the safety of both the patients and health professionals in clinical settings."

The study involved 336 adult patients with acute agitation requiring in three Australian EDs. 

Professor David Taylor from the Emergency Department at Austin Health said four to five minutes was a long time to wait for effective sedation of emergency patients with mental illness and/or intoxication.

"This drug combination is safe, fast and inexpensive and we found no negative effects," Professor Taylor said.

"The findings underscore the need for rapid and lasting sedating regimens in the ED and are good news for emergency physicians who deal with agitation and aggression among their patients on a daily basis."

More information: www.annemergmed.com/article/S0… (12)01367-4/abstract

Related Stories

Study reveals superior sedation method for children

Oct 19, 2010

Procedural sedation and analgesia is an essential element of care for children requiring painful procedures in the emergency department. The practice of combining ketamine and propofol, two common medications used in emergency ...

Physician approaches to palliative sedation

Feb 13, 2012

Physicians take two types of approaches to palliative sedation, either mild sedation or deep sedation from the start, and it is important to understand the reasons behind each approach, states an article in CMAJ (Canadian Medical A ...

Recommended for you

Meaningful relationships can help you thrive

4 hours ago

Deep and meaningful relationships play a vital role in overall well-being. Past research has shown that individuals with supportive and rewarding relationships have better mental health, higher levels of subjective well-being ...

Learning to read involves tricking the brain

4 hours ago

While reading, children and adults alike must avoid confusing mirror-image letters (like b/d or p/q). Why is it difficult to differentiate these letters? When learning to read, our brain must be able to inhibit ...

Smartphone beats paper for some with dyslexia

5 hours ago

Matthew Schneps is a researcher at Harvard University with a doctorate in physics from the Massachusetts Institute of Technology (MIT). He also happens to have dyslexia, so reading has always been a challenge for him. That ...

User comments