Tsze Daniel S, Steele Dale W, Machan Jason T, Akhlaghi Fatemeh, Linakis James G
Division of Pediatric Emergency Medicine, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Pediatr Emerg Care. 2012 Aug;28(8):767-70. doi: 10.1097/PEC.0b013e3182624935.
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.
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.
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.
Nine milligrams of INK per kilogram produced a significantly higher proportion of successful sedations than the 3- and 6-mg/kg doses.
本研究的目的是比较3种剂量的鼻内氯胺酮（INK）对1至7岁需要进行伤口缝合的儿童的镇静效果。
这是一项针对需要进行伤口缝合镇静的儿童的随机、前瞻性、双盲试验。简单伤口的患者按年龄随机接受3、6或9mg/kg的INK。使用拉姆齐镇静评分和行为痛苦观察量表修订版来衡量镇静的充分性和效果。在手术过程中抽取血清氯胺酮和去甲氯胺酮水平。记录镇静持续时间和不良事件。
在纳入的12名患者中，3名患者达到了充分镇静，均为9mg/kg剂量组。根据预定标准，该研究当时暂停。
每公斤9mg的INK产生成功镇静的比例明显高于3mg/kg和6mg/kg剂量组。
