Rescue Sedation after 5 mg or 10 mg of Droperidol for Acute Agitation in the ED

Rescue Sedation after 5 mg or 10 mg of Droperidol for Acute Agitation in the ED

Authors

Jon B. Cole, Kathryn A. Glass, Quin T. Stevens, Amber R. LeBrun, Nicholas A. Beaupre, Brian E. Driver

Journal

Journal of Emergency Medicine, 2024

Conclusions

• Patients receiving 5 mg of droperidol required less rescue sedation than those receiving 10 mg, both within 1 hour and over the course of their ED stay.
• There was a modest reduction in ED length of stay in the 5 mg group compared to the 10 mg group.

Methods

• Study Design: Single-center, retrospective analysis.
• Population: Adult ED patients receiving 5 mg or 10 mg of droperidol as the first agent for agitation treatment from 2010 to 2023.
• Primary Outcome: Requirement for rescue sedation within 1 hour of the initial droperidol dose.
• Secondary Outcomes:
• Rescue sedation at any time.
• Length of ED stay.
• Sample:
• Total patients: 11,568.
• 5 mg group: 10,293 patients.
• 10 mg group: 1,275 patients.
• Median age: 39 years (IQR 28–50).
• 72% male.
• 74% received droperidol via intramuscular injection.

Results

• Rescue Sedation within 1 Hour:
• 5 mg Group: 9.6% (987 patients).
• 10 mg Group: 14.8% (189 patients).
• Difference: 5.2% (95% CI: 3.2–7.3%).
• Rescue Sedation at Any Time:
• 5 mg Group: 17.3% (1,776 patients).
• 10 mg Group: 24.9% (318 patients).
• Difference: 7.7% (95% CI: 5.2–10.2%).
• Length of ED Stay:
• Median:
• 5 mg Group: 471 minutes (IQR: 347–611 min).
• 10 mg Group: 487 minutes (IQR: 364–641 min).
• Difference: 24 minutes (95% CI: 11–37 min).