title: Intranasal ketamine for procedural sedation in pediatric laceration repair: a preliminary report.
abstract: OBJECTIVE
  The objective of this study was to compare the efficacy of 3 doses of intranasal ketamine (INK) for sedation of children from 1 to 7 years old requiring laceration repair.
  
  
  METHODS
  This was a randomized, prospective, double-blind trial of children requiring sedation for laceration repair. Patients with simple lacerations were randomized by age to receive 3, 6, or 9 mg/kg INK. Adequacy and efficacy of sedation were measured with the Ramsay sedation score and the Observational Scale of Behavioral Distress-Revised. Serum ketamine and norketamine levels were drawn during the procedure. Sedation duration and adverse events were recorded.
  
  
  RESULTS
  Of the 12 patients enrolled, 3 patients achieved adequate sedation, all at the 9-mg/kg dose. The study was suspended at that time as per predetermined criteria.
  
  
  CONCLUSIONS
  Nine milligrams of INK per kilogram produced a significantly higher proportion of successful sedations than the 3- and 6-mg/kg doses.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, USA. dst2141@columbia.edu
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Tsze
authors.forename: Dale W
authors.initials: DW
authors.lastname: Steele
authors.forename: Jason T
authors.initials: JT
authors.lastname: Machan
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Akhlaghi
authors.forename: James G
authors.initials: JG
authors.lastname: Linakis
mesh_terms: D000281:Administration, Intranasal; D000778:Anesthetics, Dissociative / Q000008:administration & dosage* / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000097:blood; D022125:Lacerations / Q000601:surgery*; D011446:Prospective Studies
chemical_list: D000778:Anesthetics, Dissociative; D007649:Ketamine; C033419:norketamine