EFFICACY OF ORAL KETAMINE FOR PROVIDING SEDATION AND ANALGESIA TO CHILDREN REQUIRING LACERATION REPAIR

被引:39
作者
QURESHI, FA [1 ]
MELLIS, PT [1 ]
MCFADDEN, MA [1 ]
机构
[1] VIRGINIA COMMONWEALTH UNIV,MED COLL VIRGINIA,CHILDRENS MED CTR,DEPT PEDIAT,RICHMOND,VA 23298
关键词
KETAMINE; LACERATION REPAIR; SEDATION; ANALGESIA;
D O I
10.1097/00006565-199504000-00009
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
A prospective, double-blind, placebo-controlled, randomized clinical trial was conducted to study the efficacy of oral ketamine for providing sedation and analgesia to children during laceration repair, Thirty children between the ages of one and seven years with lacerations that required suturing were randomly assigned to receive either oral ketamine (10 mg/kg) or an identically flavored placebo syrup prior to suturing, Patients were assessed by means of a tolerance score reflecting behavioral correlates of perceived pain at the time of both lidocaine injection and suturing, In addition, a sedation score for monitoring patient level of consciousness was used, The ketamine-treated group demonstrated a significantly greater tolerance to both lidocaine injection (P < 0.001) and suturing (P = 0.009) in comparison to the placebo-treated group. The ketamine-treated group also achieved a significantly greater degree of sedation (P = 0.012). No significant respiratory or circulatory adverse effects were seen in either group, although 26% of patients who received ketamine experienced minor, transient adverse effects, We conclude that oral ketamine in a dose of 10 mg/kg provides effective sedation and analgesia to young children undergoing wound repair.
引用
收藏
页码:93 / 97
页数:5
相关论文
共 32 条
[1]  
Grant I.S., Nimmo W.S., McNicol L.R., Et al., Ketamine disposition in children and adults, Br.J Anaesth, 55, pp. 1107-1111, (1983)
[2]  
Green S.M., Nakamura R., Johnson N.E., Ketamine sedation for pediatric procedures: Part I. a prospective series, Ann Emerg Med, 19, pp. 1024-1032, (1990)
[3]  
Green S.M., Johnson N.E., Ketamine sedation for pediatric procedures: Part 2. review and implications, Ann Emerg Med, 19, pp. 1033-1046, (1990)
[4]  
Dailey R.H., Stone R., Repert W., Ketamine dissociative anesthesia: Emergency department use in children, J am Coll Emerg Physicians, 8, pp. 57-58, (1979)
[5]  
Elliou E., Hanid T.K., Arthur L.J., Et al., Ketamine anesthesia for medical procedures in children, Arch Dis Child, 51, pp. 56-59, (1976)
[6]  
Gutstein H.B., Johnson K.L., Heard M.B., Et al., Oral ketamine preanesthetic medication in children, Anesthesiology, 76, pp. 28-33, (1992)
[7]  
Stewart K.G., Rowbottom S.J., Aitken A.W., Et al., Oral ketamine premedication for pediatric cardiac surgery A comparison with intramuscular morphine (Both after oral trimepra/ine), Anaesth Intens Care, 18, pp. 11-14, (1990)
[8]  
Tobias J.D., Phipps S., Smith B., Et al., Oral ketamine premedication to alleviate the distress of invasive procedures in pediatric oncology patients, Pediatrics, 90, pp. 537-541, (1992)
[9]  
Rosenberg M., Oral ketamine for deep sedation of difficult to manage children who are mentally handicapped, Case Report. Pediatr Dent, 13, pp. 221-223, (1991)
[10]  
Committee on Drugs. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures, Pediatrics, 89, pp. 1110-1115, (1992)