IN Midazolam vs IN Dexmedetomidine vs IN Ketamine During Minimal Procedures in Pediatric ED

• Status: Recruiting
• Trial end date: 2024-06-01
• Target enrollment: 0
• Participant gender: All

Summary

Pain in young children has been universally under-recognized due to their inability to describe or localize pain. Improvements in pharmacological interventions are necessary to optimize patient and family experience and allow for successful and efficient procedure completion. This is the first study that will compare three intranasal medications (Intranasal Midazolam, Dexmedetomidine, and Ketamine) to evaluate the length of stay after medication administration along with patient and provider satisfaction. The objective of this study is to demonstrate superior intranasal anxiolysis for pediatric laceration repairs with the shortest emergency department stay and highest patient and provider satisfaction. Based on previous studies and medication pharmacokinetics, we hypothesize that Intranasal Ketamine will have the shortest Emergency Department (ED) stay followed by Midazolam and then Dexmedetomidine with the longest stay; however, Dexmedetomidine will have the highest patient and provider satisfaction followed by Ketamine and then Midazolam.

• Phase: Phase 4
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: University of Oklahoma
• Treatments: Dexmedetomidine; Ketamine; Midazolam

Criteria

Inclusion Criteria:

• Age 1-5 years old

• Presents to the ED for suture repair for lacerations less than or equal to 5cm in length

• Parent(s)/Caregiver(s) speak English

Exclusion Criteria:

• Younger than 12 months of age or older than 5 years old

• Suture repair needed for lacerations are greater than 5cm in length

• Known allergy or adverse effect to Midazolam, Dexmedetomidine, Ketamine, or any other sedatives

• Any abnormal vital signs for age, especially heart rate and blood pressure

• History of Cardiac, respiratory, renal, or liver disease

• Known electrolyte abnormalities

• Any ocular trauma, nasal injury, nasal deformity, significant nasal congestion, abnormalities in the nasal or oral mucosa, facial deformity, or facial injury

• Home medications include beta blockers or any other blood pressure lowering agents Classified ASA III and above

• Known or anticipated difficult airway

• Abnormal neurological exam

• Parent(s)/Caregiver(s) do not speak English