Evidence map›Paper›PMID 30617546›Full record

Observational studyJournal of anesthesia2019

Procedural sedation and analgesia in the emergency department in Japan: interim analysis of multicenter prospective observational study.

Tatsuya Norii, Yosuke Homma, Hiroyasu Shimizu, Hiroshi Takase, Sung-Ho Kim, Shimpei Nagata, Akihikari Shimosato, Cameron Crandall, Japanese Procedural Sedation and Analgesia Registry investigators

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of anesthesia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 20 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Tatsuya NoriiDepartment of Emergency Medicine, University of New Mexico, MSC11 6025, 1 UNM, Albuquerque, NM, 87131-0001, USA. TaNorii@salud.unm.edu.ORCID http://orcid.org/0000-0001-7428-5625
Yosuke HommaDepartment of Emergency and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba, 279-0001, Japan.
Hiroyasu ShimizuDepartment of Emergency and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba, 279-0001, Japan.
Hiroshi TakaseDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan.
Sung-Ho KimDepartment of Emergency Medicine, Osaka Police Hospital, 10-31, Kitayama-cho, Tennouji-ku, Osaka, 543-0035, Japan.
Shimpei NagataDepartment of Emergency Medicine, Osaka Police Hospital, 10-31, Kitayama-cho, Tennouji-ku, Osaka, 543-0035, Japan.
Akihikari ShimosatoDepartment of Anesthesiology, Kenwakai Otemachi Hospital, 15-1 Otemachi, Kokurakita-ku, Kitakyushu, Japan.
Cameron CrandallDepartment of Emergency Medicine, University of New Mexico, MSC11 6025, 1 UNM, Albuquerque, NM, 87131-0001, USA.
Japanese Procedural Sedation and Analgesia Registry investigators
University of New Mexico · USOsaka Police Hospital · JPDokkyo Medical University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProcedural sedation and analgesia (PSA) is widely performed outside of the operating theater, often in emergency departments (EDs). The practice and safety of PSA in the ED in an aging society such as in Japan have not been well described. We aimed to characterize the practice pattern of PSA including indications, pharmacology and incidence of adverse events (AEs) in Japan.

methodsWe formed the Japanese Procedural Sedation and Analgesia Registry, a multicenter prospective observation registry of ED patients undergoing PSA. We included all patients who received PSA in the ED. PSA was defined as any systemic pharmacological intervention intended to facilitate a painful or uncomfortable procedure. The main variables in this study were patients' demographics, American Society of Anesthesiologists (ASA) physical status, indication of PSA, medication choices, and AEs. The primary outcome measure was overall AEs from PSA.

resultsWe enrolled 332 patients in four EDs during the 12-month period. The median age was 67 years (IQR, 46-78). In terms of ASA physical status, 79 (23.8%), 172 (51.8%), and 81 (24.4%) patients were class 1, 2, 3 or higher, respectively. The most common indication was cardioversion (44.0%). The most common sedative used was thiopental (38.9%), followed by midazolam (34.0%) and propofol (19.6%). Among all patients, 72 (21.7%, 95% confidence interval, 17-26) patients experienced one or more AEs. The most common AE was hypoxia (9.9%), followed by apnea (7.2%) and hypotension (3.5%). All of the AEs were transient and no patient had a serious AE.

conclusionIn a multicenter prospective registry in Japan, PSA in the ED appears safe particularly since the patients who underwent PSA were older and had a higher risk profile compared to patients in previous studies in different countries.

Indexed as

Emergency Service, HospitalAgedAnalgesiaAnesthesiaElectric CountershockFemaleHumansHypnotics and SedativesJapanMaleMidazolamMiddle AgedPainProcedural SedationPropofolThiopentalHypnotics and SedativesMidazolamPropofolThiopentalEmergency departmentProcedural sedationSafety

Identifiers

PMID30617546
OpenAlexW2908893687

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.