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J Korean Soc Emerg Med > Volume 20(4); 2009 > Article
Journal of The Korean Society of Emergency Medicine 2009;20(4): 422-427.
A Comparison Study of Two Different Methods of Administration: Intranasal versus Intramuscular for Pediatric Procedural Sedation and Analgesia
Kyoung Chan An, Jung Hwan Ahn, Kug Jong Lee, Yoon Seok Jung, Sang Cheon Choi, Young Shin Cho, Ji Sook Lee, Choung Ah Lee, Gi Woon Kim
1Department of Emergency Medicine, Ajou University School of Medicine, Korea. flyingguy@ajou.ac.kr
2Member of Society for Clinical Procedures and education, Korea.
ABSTRACT
PURPOSE:
To compare the efficacy of ketamine between intranasal (IN) administration and intramuscular (IM) injection for pediatric procedural sedation and analgesia (PPSA).
METHODS:
A prospective study was conducted during 3 months. Ketamine was given by IN or IM route before primary repair of facial laceration for procedural sedation. The administration dose was 8 mg/kg for IN and 4 mg/kg for IM. We evaluated resistance scale on administration, sedation scale, satisfaction of physician and parents.
RESULTS:
One hundred children were enrolled into this study. IN administration was given to 50 children, and IM injection to 50 children each. In the IN group, 75%(36 of 50) showed severe resistance, whereas only 34%(17 of 50) showed severe resistance and 50%(25 of 50) showed mild resistance in IM group. Successful rate of sedation after initial administration was 82%(41 of 50) in IM group and 34% in IN group. Satisfaction of physicians and parents was high in IM injection group.
CONCLUSION:
Intranasal administration of Ketamine is less effective and provides lower satisfaction than intramuscular injection for procedural sedation of pediatric patients in the emergency department.
Key words: Intranasal Administration, Intramuscular Injection, Ketamine, Conscious Sedation
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