J Korean Soc Emerg Med.  2009 Aug;20(4):422-427.

A Comparison Study of Two Different Methods of Administration: Intranasal versus Intramuscular for Pediatric Procedural Sedation and Analgesia

• An KC
• Ahn JH
• Lee KJ
• Jung YS
• Choi SC
• Cho YS
• Lee JS
• Lee CA
• Kim GW

Abstract

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.

Keyword

Intranasal Administration; Intramuscular Injection; Ketamine; Conscious Sedation

MeSH Terms

Administration, Intranasal
Analgesia
Child
Conscious Sedation
Emergencies
Humans
Injections, Intramuscular
Ketamine
Lacerations
Parents
Prospective Studies
Ketamine