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Review Article
Online Published: 16 Dec 2025
 


Rapid sequence analgesia and procedural sedation for orthopedic reductions in emergency setting

Mazi Mohammed Alanazi, Manal Abdulrazaq Alanazi, Yaser Abdullah Altalhi, Nora Mohammed Alturki, Norah Dibas Aldebas, Khalid Rahil Alanazi, Jasmine Shabab Alrashidy, Abdullah Fawaz Aldossary, Hamad Ziyad Alharthi, Maha Jassim Alhamdan, Ahad Abdulaziz Alruhaymi.


Abstract
Emergency department orthopedic reductions require rapid analgesia and sedation with minimal patient disruption. This systematic review evaluated pharmacologic and regional strategies for rapid sequence analgesia and procedural sedation. Following PRISMA 2020, PubMed, Central, Elsevier (ScienceDirect), and Scopus were searched for prospective studies for patients undergoing painful orthopedic reductions in the emergency department. Eligible reports compared systemic sedative or analgesic methods, or regional nerve blocks, and reported effectiveness, time-based outcomes, or adverse events. Eight studies met the inclusion criteria. In adults, propofol-based methods shortened induction, procedure, and recovery times compared with opioid-benzodiazepine combinations, without an increase in serious respiratory or hemodynamic complications. Ultrasound-guided interscalene and suprascapular nerve blocks had similar reduction success and satisfaction to systemic sedation, but reduced length of stay and complications. Rapid sequence analgesia and procedural sedation facilitate emergency orthopedic reductions. Propofol-based strategies and ultrasound-guided nerve blocks each offer distinct advantages; system selection should be individualized to patient profile and clinician expertise.

Key words: Emergency department, procedural sedation, rapid sequence analgesia, orthopedic reduction, propofol, systematic review


 
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How to Cite this Article
Pubmed Style

Alanazi MM, Alanazi MA, Altalhi YA, Alturki NM, Aldebas ND, Alanazi KR, Alrashidy JS, Aldossary AF, Alharthi HZ, Alhamdan MJ, Alruhaymi AA. Rapid sequence analgesia and procedural sedation for orthopedic reductions in emergency setting. IJMDC. 2025; 9(11): 2999-3006. doi:10.24911/IJMDC.51-1764440374

Web Style

Alanazi MM, Alanazi MA, Altalhi YA, Alturki NM, Aldebas ND, Alanazi KR, Alrashidy JS, Aldossary AF, Alharthi HZ, Alhamdan MJ, Alruhaymi AA. Rapid sequence analgesia and procedural sedation for orthopedic reductions in emergency setting. https://www.ijmdc.com/?mno=300306 [Access: June 23, 2026]. doi:10.24911/IJMDC.51-1764440374

AMA (American Medical Association) Style

Alanazi MM, Alanazi MA, Altalhi YA, Alturki NM, Aldebas ND, Alanazi KR, Alrashidy JS, Aldossary AF, Alharthi HZ, Alhamdan MJ, Alruhaymi AA. Rapid sequence analgesia and procedural sedation for orthopedic reductions in emergency setting. IJMDC. 2025; 9(11): 2999-3006. doi:10.24911/IJMDC.51-1764440374


Vancouver/ICMJE Style

Alanazi MM, Alanazi MA, Altalhi YA, Alturki NM, Aldebas ND, Alanazi KR, Alrashidy JS, Aldossary AF, Alharthi HZ, Alhamdan MJ, Alruhaymi AA. Rapid sequence analgesia and procedural sedation for orthopedic reductions in emergency setting. IJMDC. (2025), [cited June 23, 2026]; 9(11): 2999-3006. doi:10.24911/IJMDC.51-1764440374


Harvard Style

Alanazi, M. M., Alanazi, . M. A., Altalhi, . Y. A., Alturki, . N. M., Aldebas, . N. D., Alanazi, . K. R., Alrashidy, . J. S., Aldossary, . A. F., Alharthi, . H. Z., Alhamdan, . M. J. & Alruhaymi, . A. A. (2025) Rapid sequence analgesia and procedural sedation for orthopedic reductions in emergency setting. IJMDC, 9 (11), 2999-3006. doi:10.24911/IJMDC.51-1764440374


Turabian Style

Alanazi, Mazi Mohammed, Manal Abdulrazaq Alanazi, Yaser Abdullah Altalhi, Nora Mohammed Alturki, Norah Dibas Aldebas, Khalid Rahil Alanazi, Jasmine Shabab Alrashidy, Abdullah Fawaz Aldossary, Hamad Ziyad Alharthi, Maha Jassim Alhamdan, and Ahad Abdulaziz Alruhaymi. 2025. Rapid sequence analgesia and procedural sedation for orthopedic reductions in emergency setting. International Journal of Medicine in Developing Countries, 9 (11), 2999-3006. doi:10.24911/IJMDC.51-1764440374


Chicago Style

Alanazi, Mazi Mohammed, Manal Abdulrazaq Alanazi, Yaser Abdullah Altalhi, Nora Mohammed Alturki, Norah Dibas Aldebas, Khalid Rahil Alanazi, Jasmine Shabab Alrashidy, Abdullah Fawaz Aldossary, Hamad Ziyad Alharthi, Maha Jassim Alhamdan, and Ahad Abdulaziz Alruhaymi. "Rapid sequence analgesia and procedural sedation for orthopedic reductions in emergency setting." International Journal of Medicine in Developing Countries 9 (2025), 2999-3006. doi:10.24911/IJMDC.51-1764440374


MLA (The Modern Language Association) Style

Alanazi, Mazi Mohammed, Manal Abdulrazaq Alanazi, Yaser Abdullah Altalhi, Nora Mohammed Alturki, Norah Dibas Aldebas, Khalid Rahil Alanazi, Jasmine Shabab Alrashidy, Abdullah Fawaz Aldossary, Hamad Ziyad Alharthi, Maha Jassim Alhamdan, and Ahad Abdulaziz Alruhaymi. "Rapid sequence analgesia and procedural sedation for orthopedic reductions in emergency setting." International Journal of Medicine in Developing Countries 9.11 (2025), 2999-3006. Print. doi:10.24911/IJMDC.51-1764440374


APA (American Psychological Association) Style

Alanazi, M. M., Alanazi, . M. A., Altalhi, . Y. A., Alturki, . N. M., Aldebas, . N. D., Alanazi, . K. R., Alrashidy, . J. S., Aldossary, . A. F., Alharthi, . H. Z., Alhamdan, . M. J. & Alruhaymi, . A. A. (2025) Rapid sequence analgesia and procedural sedation for orthopedic reductions in emergency setting. International Journal of Medicine in Developing Countries, 9 (11), 2999-3006. doi:10.24911/IJMDC.51-1764440374




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