What are adjuncts to procedural sedation?

Updated: Nov 06, 2018
  • Author: Arul M Lingappan, MD; Chief Editor: Erik D Schraga, MD  more...
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Procedural sedation has many adjuncts that could be used to decrease the dosage requirement of medications or even remove the need for sedation altogether. Hematoma blocks can be used in patients with long bone fractures (classically performed in distal radial fractures). A recent systematic review showed that intraarticular lidocaine injection for long bone fractures resulted in significantly fewer complications when compared to procedural sedation with opiates and benzodiazepines (0.67% vs 13%, respectively), and shorter ED stays. [58]

Digital and regional nerve blocks can be performed with anxiolytic-dose procedural sedation as an alternative to moderate or deep sedation, thus decreasing the potential risks seen with these levels of sedation. This practice can be useful in adults and children. [59]

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