Intranasal ketamine for procedural sedation in pediatric laceration repair: a preliminary report.

Abstract

OBJECTIVE:

The objective of this study was to compare the efficacy of 3 doses of intranasal ketamine (INK) for sedation of children from 1 to 7 years old requiring laceration repair.

METHODS:

This was a randomized, prospective, double-blind trial of children requiring sedation for laceration repair. Patients with simple lacerations were randomized by age to receive 3, 6, or 9 mg/kg INK. Adequacy and efficacy of sedation were measured with the Ramsay sedation score and the Observational Scale of Behavioral Distress-Revised. Serum ketamine and norketamine levels were drawn during the procedure. Sedation duration and adverse events were recorded.

RESULTS:

Of the 12 patients enrolled, 3 patients achieved adequate sedation, all at the 9-mg/kg dose. The study was suspended at that time as per predetermined criteria.

CONCLUSIONS:

Nine milligrams of INK per kilogram produced a significantly higher proportion of successful sedations than the 3- and 6-mg/kg doses.

• Authors: Daniel S Tsze, Dale W Steele, Jason T Machan, Fatemeh Akhlaghi, James G Linakis
• Journal: Pediatric emergency care (Pediatr Emerg Care) Vol. 28 Issue 8 Pg. 767-70 (Aug 2012) ISSN: 1535-1815 [Electronic] United States
• PMID: 22858745 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anesthetics, Dissociative
• Ketamine
• norketamine

Topics

• Administration, Intranasal
• Anesthetics, Dissociative (administration & dosage, blood)
• Child
• Child, Preschool
• Dose-Response Relationship, Drug
• Double-Blind Method
• Humans
• Infant
• Ketamine (administration & dosage, analogs & derivatives, blood)
• Lacerations (surgery)
• Prospective Studies