Dexmedetomidine vs Ketamine for Pediatric Procedural Sedation in the Emergency Department: A Randomized Clinical Trial.

Bulletin of emergency and trauma Pub Date : 2023-01-01 DOI:10.30476/BEAT.2022.95647.1366

Behrang Rezvani Kakhki, Melika Fugerdi, Zahra Abbasishaye, Hamideh Feyz Dysfani, Elnaz Vafadar Moradi

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Abstract

Objective: To design and conduct the effectiveness of Ketamine vs Dexmedetomidine in children's sedation at emergency department (ED).

Methods: This randomized clinical trial study was carried out at the two trauma centers in Mashhad, Iran. The patients were divided into two groups by means of a random numbers table to be treated with Ketamine (N=20) or Dexmedetomidine (N=20). Their demographic information and sedation times of drugs were collected and analyzed.

Results: In general, sedation time was significantly higher in the ketamine group, 14.35 minutes (IQR:9.82-19) than in the dexmedetomidine group, 9.7 minutes (8.35-14.23) (p=0.023). Time of injection to complete anesthesia was 45.25 (IQR:30-58) and 72 (IQR:60.25-82) minutes in ketamine and dexmedetomidine groups, respectively (p<0.01). In the case of recovery, grade 4 of the Ramsey scale was statistically more prevalent in dexmedetomidine (45%) than in the ketamine group (p=0.0001).

Conclusion: This study demonstrated that dexmedetomidine could be used in cases where a shorter sedation time is vital. Ketamine could be a better choice where full recovery time (from injection) matters most. Clinical Trial registration code: IR.MUMS.fm.REC.1396.534.

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右美托咪定与氯胺酮在急诊科的儿科手术镇静:一项随机临床试验

目的:设计并评价氯胺酮与右美托咪定在急诊科儿童镇静中的应用效果。方法:本随机临床试验研究在伊朗马什哈德的两家创伤中心进行。采用随机数字表法将患者分为两组，分别给予氯胺酮(N=20)或右美托咪定(N=20)治疗。收集并分析患者的人口学信息和药物镇静时间。结果:总体而言，氯胺酮组镇静时间为14.35 min (IQR:9.82 ~ 19)显著高于右美托咪定组的9.7 min (8.35 ~ 14.23) (p=0.023)。氯胺酮组和右美托咪定组注射至完全麻醉时间分别为45.25 (IQR:30 ~ 58)和72 (IQR:60.25 ~ 82) min (pp=0.0001)。结论:本研究表明右美托咪定可用于较短镇静时间至关重要的病例。氯胺酮可能是一个更好的选择，在完全恢复时间(注射后)最重要。临床试验注册代码:IR.MUMS.fm.REC.1396.534。

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来源期刊

Bulletin of emergency and trauma

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0.00%

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审稿时长

12 weeks

期刊介绍： BEAT: Bulletin of Emergency And Trauma is an international, peer-reviewed, quarterly journal coping with original research contributing to the field of emergency medicine and trauma. BEAT is the official journal of the Trauma Research Center (TRC) of Shiraz University of Medical Sciences (SUMS), Hungarian Trauma Society (HTS) and Lusitanian Association for Trauma and Emergency Surgery (ALTEC/LATES) aiming to be a publication of international repute that serves as a medium for dissemination and exchange of scientific knowledge in the emergency medicine and trauma. The aim of BEAT is to publish original research focusing on practicing and training of emergency medicine and trauma to publish peer-reviewed articles of current international interest in the form of original articles, brief communications, reviews, case reports, clinical images, and letters.