Elbow Dislocation Medication

Updated: Sep 26, 2017
  • Author: Mark E Halstead, MD; Chief Editor: Craig C Young, MD  more...
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Medication

Medication Summary

Use of medication for elbow dislocations is beneficial in the acute setting when reduction of the dislocation is to take place. Choosing both an anxiolytic and a pain medication is ideal for a conscious sedation to facilitate reduction. Once reduction has occurred, pain may still be an issue, and it would be reasonable to provide the patient with oral pain medication to use in the outpatient setting.

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Anxiolytics

Class Summary

Anxiolytics allow for relaxation and mild sedation when reduction of a dislocated elbow is attempted. These agents also allow for a lower dose of analgesics to be used.

Midazolam (Versed)

DOC for anxiolytics. Shorter-acting benzodiazepine sedative-hypnotic that is useful in patients requiring acute and/or short-term sedation. Midazolam is also useful for its amnestic effects.

Lorazepam (Ativan)

Sedative hypnotic with short onset of effects and a relatively long half-life. By increasing the action of gamma-aminobutyric acid (GABA), which is a major inhibitory neurotransmitter in the brain, this agent may depress all levels of CNS, including the limbic and reticular formation. When the patient needs to be sedated for longer than a 24-hour period, this medication is excellent.

Diazepam (Valium)

Depresses all levels of the CNS (eg, limbic and reticular formation), possibly by increasing the activity of GABA. Individualize the dosage and increase cautiously to avoid adverse effects.

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Analgesics

Class Summary

Pain control is essential to quality patient care. Analgesics ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients who have sustained trauma or who have sustained injuries.

Morphine (Duramorph, Astramorph, MS Contin)

Indicated for moderate to severe acute and chronic pain.

Fentanyl (Duragesic, Sublimaze)

Potent narcotic analgesic with a much shorter half-life than morphine sulfate. DOC for conscious sedation analgesia. Ideal for analgesic action of short duration during anesthesia and immediate postoperative period.

Excellent choice for pain management and sedation with short duration (30-60 min) and easy to titrate. Easily and quickly reversed by naloxone. After initial dose, the subsequent doses should not be titrated more frequently than q3h or q6h thereafter.

When using the transdermal dosage form, most patients are controlled with 72 h dosing intervals. However, some patients require dosing intervals of 48 h.

Oxycodone and acetaminophen (Percocet, Roxicet)

Drug combination indicated for the relief of moderate to severe pain.

Acetaminophen and codeine (Tylenol with codeine, Tylenol #3)

Indicated for the treatment of mild to moderate pain.

Acetaminophen and hydrocodone (Vicodin, Hydrocet, Lorcet)

Drug combination indicated for moderate to severe pain.

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