Naveen Poonai1,2,3, Kyle Canton2, Samina Ali4,5, Shawn Hendrikx1, Amit Shah2, Michael Miller1,3, Gary Joubert1,2,3, Lisa Hartling6. 1. Department of Pediatrics, Schulich School of Medicine & Dentistry, London, Canada. 2. Division of Emergency Medicine, Western University, London, Canada. 3. Children's Health Research Institute, London Health Sciences Centre, London, Canada. 4. Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada. 5. Women & Children's Health Research Institute, University of Alberta, Edmonton, Canada. 6. Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Canada.
Abstract
AIM: In children, intravenous anesthetic premedication can be distressing. Intranasal (IN) ketamine offers a less invasive approach. MATERIALS AND METHODS: We included randomized trials of IN ketamine in anesthetic premedication in children 0-19 years. We performed electronic searches of MEDLINE, EMBASE, Google Scholar, CINAHL, Cochrane Library, Web of Science, Scopus, clinical trial registries and conference proceedings. RESULTS: Among the 23 trials (n = 1680) included, IN ketamine adequately sedated 220/311 (70%) for face mask application, 217/308 (70%) for caregiver separation, 200/371 (54%) for iv. insertion and 19/30 (63%) for monitor application. Vomiting was the most common adverse effect (35/1579 [2.2%]). CONCLUSION: There is a need for sufficiently powered, methodologically rigorous trials, using psychometrically evaluated, objective outcome measures to meaningfully inform practice.
AIM: In children, intravenous anesthetic premedication can be distressing. Intranasal (IN) ketamine offers a less invasive approach. MATERIALS AND METHODS: We included randomized trials of IN ketamine in anesthetic premedication in children 0-19 years. We performed electronic searches of MEDLINE, EMBASE, Google Scholar, CINAHL, Cochrane Library, Web of Science, Scopus, clinical trial registries and conference proceedings. RESULTS: Among the 23 trials (n = 1680) included, IN ketamine adequately sedated 220/311 (70%) for face mask application, 217/308 (70%) for caregiver separation, 200/371 (54%) for iv. insertion and 19/30 (63%) for monitor application. Vomiting was the most common adverse effect (35/1579 [2.2%]). CONCLUSION: There is a need for sufficiently powered, methodologically rigorous trials, using psychometrically evaluated, objective outcome measures to meaningfully inform practice.
Authors: Thomas Cristoforo; Dulce Gonzalez; Mark Bender; Geraldine Uy; Linda Papa; Bertha A Ben Khallouq; Mark Clark; Brandon Carr; Kelly Cramm Journal: J Child Adolesc Trauma Date: 2021-09-13