J Korean Soc Emerg Med.  2006 Dec;17(6):623-629.

The Comparison of Sedative Efficacy and Safety of Oral Chloral Hydrate and Intramuscular Ketamine in Children for Primary Repair in Emergency Department

Affiliations
  • 1Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon, Korea. rs0505@cnuh.co.kr
  • 2Department of Emergency Medicine, College of Medicine, Yonsei University, Seoul, Korea.

Abstract

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+/-SD. 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+/-0.32 versus 4.23+/-0.48; 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.

Keyword

Conscious; Sedation; Chloral hydrate; Ketamine

MeSH Terms

Anesthesia, Local
Blood Pressure
Body Weight
Child*
Chloral Hydrate*
Emergencies*
Emergency Service, Hospital*
Humans
Ketamine*
Lacerations
Lidocaine
Vital Signs
Chloral Hydrate
Ketamine
Lidocaine
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