STUDY OBJECTIVE: We investigate the effect of ondansetron on the incidence of vomiting in children who receive intravenous (IV) ketamine for procedural sedation and analgesia in the emergency department (ED). METHODS: In this double-blind, randomized, placebo-controlled trial in a children's hospital ED, patients receivingIV ketamine (1 mg/kg) for ED procedures were randomized to receive either IV ondansetron (0.15 mg/kg; maximum 4 mg) or identical placebo. We recorded whether vomiting occurred in the ED postsedation or up to 12 hours after discharge with telephone follow-up and compared ED length of stay and parental satisfaction. RESULTS:One hundred twenty-seven children were randomized to placebo and 128 to ondansetron. The groups were similar in age, sex, and fasting duration. ED vomiting was less common with ondansetron: 6 of 128 (4.7%) versus 16 of 127 (12.6%), P=.02, difference 7.9% (95% confidence interval 1.1% to 14.7%), number needed to treat 13. Follow-up was successful in 82.7%, with vomiting in the ED or after discharge less frequent with ondansetron: 10 of 128 (7.8%) versus 24 of 127 (18.9%), P=.01, difference 11.1% (95% confidence interval 2.7% to 19.5%), number needed to treat 9. ED length of stay and parental satisfaction were similar between groups. CONCLUSION:IV ondansetron significantly reduces the incidence of vomiting associated with IV ketamine procedural sedation in children.
RCT Entities:
STUDY OBJECTIVE: We investigate the effect of ondansetron on the incidence of vomiting in children who receive intravenous (IV) ketamine for procedural sedation and analgesia in the emergency department (ED). METHODS: In this double-blind, randomized, placebo-controlled trial in a children's hospital ED, patients receiving IV ketamine (1 mg/kg) for ED procedures were randomized to receive either IV ondansetron (0.15 mg/kg; maximum 4 mg) or identical placebo. We recorded whether vomiting occurred in the ED postsedation or up to 12 hours after discharge with telephone follow-up and compared ED length of stay and parental satisfaction. RESULTS: One hundred twenty-seven children were randomized to placebo and 128 to ondansetron. The groups were similar in age, sex, and fasting duration. ED vomiting was less common with ondansetron: 6 of 128 (4.7%) versus 16 of 127 (12.6%), P=.02, difference 7.9% (95% confidence interval 1.1% to 14.7%), number needed to treat 13. Follow-up was successful in 82.7%, with vomiting in the ED or after discharge less frequent with ondansetron: 10 of 128 (7.8%) versus 24 of 127 (18.9%), P=.01, difference 11.1% (95% confidence interval 2.7% to 19.5%), number needed to treat 9. ED length of stay and parental satisfaction were similar between groups. CONCLUSION: IV ondansetron significantly reduces the incidence of vomiting associated with IV ketamine procedural sedation in children.
Authors: Maala Bhatt; David W Johnson; Jason Chan; Monica Taljaard; Nick Barrowman; Ken J Farion; Samina Ali; Suzanne Beno; Andrew Dixon; C Michelle McTimoney; Alexander Sasha Dubrovsky; Nadia Sourial; Mark G Roback Journal: JAMA Pediatr Date: 2017-10-01 Impact factor: 16.193
Authors: Sri S Chinta; Charles R Schrock; John D McAllister; David M Jaffe; Jingxia Liu; Robert M Kennedy Journal: Ann Emerg Med Date: 2015-01-14 Impact factor: 5.721
Authors: Jocelyn R Grunwell; Curtis Travers; Courtney E McCracken; Patricia D Scherrer; Anne G Stormorken; Corrie E Chumpitazi; Mark G Roback; Jana A Stockwell; Pradip P Kamat Journal: Pediatr Crit Care Med Date: 2016-12 Impact factor: 3.624