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KMID : 0385920090200040422
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Journal of the Korean Society of Emergency Medicine
2009 Volume.20 No. 4 p.422 ~ p.427
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A Comparison Study of Two Different Methods of Administration: Intranasal versus Intramuscular for Pediatric Procedural Sedation and Analgesia
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An Kyoung-Chan
Lee Coook-Jong
Ahn Jung-Hwan
Jung Yoon-Seok
Choi Sang-Cheon
Cho Young-Shin
Lee Ji-Sook
Lee Choung-Ah
Kim Gi-Woon
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Abstract
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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.
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KEYWORD
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Intranasal Administration, Intramuscular Injection, Ketamine, Conscious Sedation
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