Low-Dose Intravenous Ketamine Bolus Versus Conventional Technique
Status:
Unknown status
Trial end date:
2018-05-14
Target enrollment:
Participant gender:
Summary
Abstract Background: Ketamine has been introduced as one of the most common drugs,
administered to sedate children for different painful procedures in the emergency department
(ED) but administration in higher dosage causes some severe complications. Thus, the aim of
this study was to evaluate the effect of low-dose intravenous ketamine bolus versus
conventional injection for reduction of upper and lower extremity fractures in children.
Materials and Methods: In this randomized clinical trial, 198 participants with upper and
lower extremity fractures were enrolled. The participants were divided randomly into two
groups. In the intervention group, ketamine 1% was administered rapidly at a dose of 0.5 mg /
kg (within 5 seconds), and in the control group, ketamine 1.5 mg / kg was slowly injected for
30 to 60 seconds. Then outcomes such as sedation depth and complications were measured for
every two minutes and satisfaction of participants and physicians were recorded.
Results: Results showed that the successful sedation rate in the low dose ketamine group was
significantly lower, as compared to the control group (7% vs 100%) (p<0.001). Moreover, In
terms of duration of drug effect and of recovery, the low dose ketamine group were
significantly lower compared with the group receiving higher dosage of ketamine (p<0.05).
Furthermore, the sedation depth based on Wisconsin Sedation Scale was significantly higher,
in the low dose ketamine group compared to the other group. By evaluating different
complications, we found that the rate of neurological (20.4 % vs 5%) and physiological (10.2%
vs 2%) complications in the control group was significantly higher compared to the group
receiving low-dose ketamine (p<0.05).