Chemical restraint for the agitated patient in the emergency department: Lorazepam versus droperidol

John R Richards, Robert W. Derlet, David R. Duncan

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

Patients presenting to the emergency department with acute agitation frequently require physical and chemical restraint. To determine the efficacy of lorazepam vs. droperidol, we conducted a prospective, randomized study of violently agitated patients requiring chemical restraint. Patients were randomized to receive either lorazepam or droperidol i.v. A six-point sedation scale was used. Sedation scores were recorded at time 0, 5, 10, 15, 30, and 60 min. Vital signs were compared at time 0 and at 60 min. Repeat dosages of each drug could be given at 30 min. Toxicology screen, ethanol and creatinine phosphokinase levels were obtained. A total of 202 patients were evaluated. One hundred patients received lorazepam and 102 patient received droperidol. Agitation was attributed to methamphetamine toxicity in 146 patients (72%), cocaine toxicity in 28 (14%), psychiatric illness in 20 (10%), and ethanol withdrawal in 8 (4%). Ethanol intoxication was present in 98 patients (49%). Both drugs had similar sedation profiles at 5 min. Patients receiving droperidol had significantly lower sedation scores at times 10, 15, 30, and 60 than lorazepam. More repeat doses of lorazepam were given (40) than droperidol (8) at 30 min. We conclude that droperidol produces a more rapid and better sedation than lorazepam at the doses used in this study in agitated patients requiring chemical restraint. Lorazepam is more likely to require repeat dosing than droperidol. Methamphetamine toxicity was present in the majority of patients in this study.

Original languageEnglish (US)
Pages (from-to)567-573
Number of pages7
JournalJournal of Emergency Medicine
Volume16
Issue number4
DOIs
StatePublished - Jul 1998

Fingerprint

Droperidol
Lorazepam
Hospital Emergency Service
Ethanol
Methamphetamine
Physical Restraint
Vital Signs
Cocaine
Pharmaceutical Preparations
Toxicology
Psychiatry
Creatinine
Phosphotransferases

Keywords

  • Agitation
  • Chemical restraint
  • Droperidol
  • Lorazepam

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Chemical restraint for the agitated patient in the emergency department : Lorazepam versus droperidol. / Richards, John R; Derlet, Robert W.; Duncan, David R.

In: Journal of Emergency Medicine, Vol. 16, No. 4, 07.1998, p. 567-573.

Research output: Contribution to journalArticle

@article{3cb828f35f76474b82ef3c6e146463ba,
title = "Chemical restraint for the agitated patient in the emergency department: Lorazepam versus droperidol",
abstract = "Patients presenting to the emergency department with acute agitation frequently require physical and chemical restraint. To determine the efficacy of lorazepam vs. droperidol, we conducted a prospective, randomized study of violently agitated patients requiring chemical restraint. Patients were randomized to receive either lorazepam or droperidol i.v. A six-point sedation scale was used. Sedation scores were recorded at time 0, 5, 10, 15, 30, and 60 min. Vital signs were compared at time 0 and at 60 min. Repeat dosages of each drug could be given at 30 min. Toxicology screen, ethanol and creatinine phosphokinase levels were obtained. A total of 202 patients were evaluated. One hundred patients received lorazepam and 102 patient received droperidol. Agitation was attributed to methamphetamine toxicity in 146 patients (72{\%}), cocaine toxicity in 28 (14{\%}), psychiatric illness in 20 (10{\%}), and ethanol withdrawal in 8 (4{\%}). Ethanol intoxication was present in 98 patients (49{\%}). Both drugs had similar sedation profiles at 5 min. Patients receiving droperidol had significantly lower sedation scores at times 10, 15, 30, and 60 than lorazepam. More repeat doses of lorazepam were given (40) than droperidol (8) at 30 min. We conclude that droperidol produces a more rapid and better sedation than lorazepam at the doses used in this study in agitated patients requiring chemical restraint. Lorazepam is more likely to require repeat dosing than droperidol. Methamphetamine toxicity was present in the majority of patients in this study.",
keywords = "Agitation, Chemical restraint, Droperidol, Lorazepam",
author = "Richards, {John R} and Derlet, {Robert W.} and Duncan, {David R.}",
year = "1998",
month = "7",
doi = "10.1016/S0736-4679(98)00045-6",
language = "English (US)",
volume = "16",
pages = "567--573",
journal = "Journal of Emergency Medicine",
issn = "0736-4679",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Chemical restraint for the agitated patient in the emergency department

T2 - Lorazepam versus droperidol

AU - Richards, John R

AU - Derlet, Robert W.

AU - Duncan, David R.

PY - 1998/7

Y1 - 1998/7

N2 - Patients presenting to the emergency department with acute agitation frequently require physical and chemical restraint. To determine the efficacy of lorazepam vs. droperidol, we conducted a prospective, randomized study of violently agitated patients requiring chemical restraint. Patients were randomized to receive either lorazepam or droperidol i.v. A six-point sedation scale was used. Sedation scores were recorded at time 0, 5, 10, 15, 30, and 60 min. Vital signs were compared at time 0 and at 60 min. Repeat dosages of each drug could be given at 30 min. Toxicology screen, ethanol and creatinine phosphokinase levels were obtained. A total of 202 patients were evaluated. One hundred patients received lorazepam and 102 patient received droperidol. Agitation was attributed to methamphetamine toxicity in 146 patients (72%), cocaine toxicity in 28 (14%), psychiatric illness in 20 (10%), and ethanol withdrawal in 8 (4%). Ethanol intoxication was present in 98 patients (49%). Both drugs had similar sedation profiles at 5 min. Patients receiving droperidol had significantly lower sedation scores at times 10, 15, 30, and 60 than lorazepam. More repeat doses of lorazepam were given (40) than droperidol (8) at 30 min. We conclude that droperidol produces a more rapid and better sedation than lorazepam at the doses used in this study in agitated patients requiring chemical restraint. Lorazepam is more likely to require repeat dosing than droperidol. Methamphetamine toxicity was present in the majority of patients in this study.

AB - Patients presenting to the emergency department with acute agitation frequently require physical and chemical restraint. To determine the efficacy of lorazepam vs. droperidol, we conducted a prospective, randomized study of violently agitated patients requiring chemical restraint. Patients were randomized to receive either lorazepam or droperidol i.v. A six-point sedation scale was used. Sedation scores were recorded at time 0, 5, 10, 15, 30, and 60 min. Vital signs were compared at time 0 and at 60 min. Repeat dosages of each drug could be given at 30 min. Toxicology screen, ethanol and creatinine phosphokinase levels were obtained. A total of 202 patients were evaluated. One hundred patients received lorazepam and 102 patient received droperidol. Agitation was attributed to methamphetamine toxicity in 146 patients (72%), cocaine toxicity in 28 (14%), psychiatric illness in 20 (10%), and ethanol withdrawal in 8 (4%). Ethanol intoxication was present in 98 patients (49%). Both drugs had similar sedation profiles at 5 min. Patients receiving droperidol had significantly lower sedation scores at times 10, 15, 30, and 60 than lorazepam. More repeat doses of lorazepam were given (40) than droperidol (8) at 30 min. We conclude that droperidol produces a more rapid and better sedation than lorazepam at the doses used in this study in agitated patients requiring chemical restraint. Lorazepam is more likely to require repeat dosing than droperidol. Methamphetamine toxicity was present in the majority of patients in this study.

KW - Agitation

KW - Chemical restraint

KW - Droperidol

KW - Lorazepam

UR - http://www.scopus.com/inward/record.url?scp=0032127626&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032127626&partnerID=8YFLogxK

U2 - 10.1016/S0736-4679(98)00045-6

DO - 10.1016/S0736-4679(98)00045-6

M3 - Article

C2 - 9696171

AN - SCOPUS:0032127626

VL - 16

SP - 567

EP - 573

JO - Journal of Emergency Medicine

JF - Journal of Emergency Medicine

SN - 0736-4679

IS - 4

ER -