Comparison of the Efficacy and Side Effects of Intravenous and Intramuscular Injection of Ketamine for Children Requiring Sedation: A Randomized Double-Blind Clinical Trial Study

Authors

1 Department of Emergency Medicine, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Department of Emergency Medicine, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran AND Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Abstract

Background
Ketamine is an antagonist receptor of N-methyl-D-aspartate (NMDA), and phencyclidine derivate sedative agent. Thus the aim of this study was to evaluate the effect of intravenous (IV) and intramuscular (IM) injection of Ketamine for sedation procedure of children.
Materials and Methods
In this randomized clinical trial the patients, 1-6 year-old children referred to Emergency Department of Ahvaz Golestan and Imam Khomeini Hospitals, Ahvaz city, Iran, were divided randomly into two groups (IV and IM groups). Patients in the IV group received ketamine with dose of 1.5 mg/kg intravenously and the patients in the IM group received ketamine with dose of 4 mg/kg intramuscularly. Then efficacy and side effects in both groups were performed every 5 minutes for the first for the first 15 minutes.
Results
222 patients with indication for sedation were enrolled. Results showed that in 1st min, most of the patients that received IM ketamine were in level 1 of sedation (67.6 %, n= 73); while  the majority of patients that received IV ketamine were in level 1 to 3 of sedation (28.9%, 24.6% and 26.3%, respectively) (P<0.001). Moreover, in 5th min, most of the patients that received IV ketamine were in level 6 of sedation (62.3%), while those who received IM ketamine were in level 5 of sedation (52.8%) (P<0.001), which was better in IV group. While in 15th min, we did not find significant differences between the groups (P=0.057).
Conclusion
The results of this study showed the beneficial effects of IV ketamine in making better sedation levels in pediatric patients for different purpose (medical and para-clinical procedures).

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