This determines the equipment that one should have readily available prior to starting the procedure.Individual patient response to medications can vary; therefore, the clinician can potentially overshoot the desired level of anesthesia.Sedation is the depression of a patient's awareness to the environment and reduction of his or her responsiveness to external stimulation.This is accomplished along a continuum of sedation levels: Prior to the administration of medications, clinicians must know the level of sedation required for a given procedure and the appropriate dose of the pharmacologic agent or agents chosen.The duration of action is about 30 minutes, although sedation may be prolonged in elderly patients. It is an intermediate-acting benzodiazepine; its effects begin within 3-5 minutes and peak at 20-30 minutes. Lorazepam has a few advantages over midazolam: first, metabolism occurs by means of conjugation, which makes it more suitable than other benzodiazepines for use in the presence of renal or hepatic failure.
One of the most important goals of clinicians is patient comfort.
Midazolam is the fastest acting of its class because of its lipophilic abilities, and it is superior to lorazepam and diazepam in its amnestic effects, making it the ideal benzodiazepine for use in short ED procedures. Thus, it can be given as a continuous intravenous infusion (0.03-0.1 mg/kg/h) with less concern for adverse effects than an intravenous midazolam drip.
For this reason, it is the preferred agent for continuous administration.
When patients present to the emergency department (ED), treating the pain and anxiety that accompany the chief complaint are critical to patient satisfaction and quality of care.
Nonetheless, clinicians may underuse sedation, usually from a lack of experience or from unchallenged myths regarding its use.