KMID : 0385920060170060623
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Journal of the Korean Society of Emergency Medicine 2006 Volume.17 No. 6 p.623 ~ p.629
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The Comparison of Sedative Efficacy and Safety of Oral Chloral Hydrate and Intramuscular Ketamine in Children for Primary Repair in Emergency Department
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Min Jin-Hong
Do Hyun-Soo Hong Seung-Woo Jeong Won-Joon Lee Won-Suk Yi Hwa-Yeon Ryu Seung Kim Seung-Hwan Chung Sung-Phil Yoo In-Sool
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Abstract
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Purpose: To compare the sedation quality of oral chloral hydrate against intramuscular ketamine in children requiring primary repair in the emergency department.
Methods: Patients needing primary repair of lacerations (range 1~6 years of age) were blindly randomized to either chloral hydrate or ketamine groups. One group received intramuscular ketamine at 4 mg/kg and the other group received oral chloral hydrate at 50 mg/kg. Both groups received lidocaine for local anesthesia. Physiologic parameters (heart rate, blood pressure and respiratory rate), the time from sedation to recovery, and the degree of sedation as measured by the Ramsay sedation score and the Modified Aldrete recovery score were recorded during the treatment. Overall behavior and complication were assessed both at baseline and at the end of the treatment.
Results: Data are mean¡¾SD. We enrolled 80 consecutive patients into the study; 39 received intramuscular ketamine and 41 were administered oral chloral hydrate. The two groups were similar with regard to age, sex, and body weights. No patient had a clinically significant change in vital signs and the time from sedation to recovery. Changes in the Modified Aldrete recovery score after sedation were not statistically significant. However, statistically significant differences were observed for the Ramsay sedation score at 15 minutes after sedation (4.89¡¾0.32 versus 4.23¡¾0.48; p=0.024). No differences at other time points achieved statistical significance in the Ramsay sedation score.
Conclusion: Both oral chloral hydrate and intramuscular ketamine are safe and effective for the sedation of children requiring laceration repair in the emergency department.
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KEYWORD
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Conscious, Sedation, Chloral hydrate, Ketamine
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