• S W Wright, C R Chudnofsky, S C Dronen, R Kothari, P Birrer, D M Blanton, and A Bruner.
• Vanderbilt University, Nashville, Tennessee.
• Ann Emerg Med. 1993 Feb 1; 22 (2): 201-5.

Study ObjectiveTo compare the efficacy of diazepam and midazolam when used for conscious sedation in emergency department patients.DesignProspective, randomized, double-blind, multicenter trial.SettingThree university EDs.Type Of ParticipantsPatients requiring one of the following procedures: abscess drainage, joint reduction, extensive suturing, chest tube insertion, or lumbar puncture.InterventionsDiazepam (2.5 mg/mL) or midazolam (1 mg/mL) was administered until the desired level of sedation was achieved to a maximum of 5 mL. Fentanyl citrate was administered if needed for pain.Measurements And Main ResultsThirty-three patients received diazepam and 36 received midazolam. Patients receiving midazolam had a greater degree of early sedation (P < .05), a higher 90-minute alertness scale score (P < .05), more patients ready for discharge at 90 minutes (P = .05), significantly less recall for the procedure (P < .02), and less pain on injection (P < .01) than patients who were given diazepam.ConclusionsDiazepam and midazolam are both effective for conscious sedation in ED patients. Midazolam causes less pain on injection, a significantly greater degree of early sedation, and a more rapid return to baseline function.

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