Efficacy of oral ketamine for providing sedation and analgesia to children requiring laceration repair

Abstract

A prospective, double-blind, placebo-controlled, randomized clinical trial was conducted to study the efficacy of oral ketamine for providing sedation and analgesia to children during laceration repair. Thirty children between the ages of one and seven years with lacerations that required suturing were randomly assigned to receive either oral ketamine (10 mg/kg) or an identically flavored placebo syrup prior to suturing. Patients were assessed by means of a tolerance score reflecting behavioral correlates of perceived pain at the time of both lidocaine injection and suturing. In addition, a sedation score for monitoring patient level of consciousness was used. The ketamine-treated group demonstrated a significantly greater tolerance to both lidocaine injection (P < 0.001) and suturing (P = 0.009) in comparison to the placebo-treated group. The ketamine-treated group also achieved a significantly greater degree of sedation (P = 0.012). No significant respiratory or circulatory adverse effects were seen in either group, although 26% of patients who received ketamine experienced minor, transient adverse effects. We conclude that oral ketamine in a dose of 10 mg/kg provides effective sedation and analgesia to young children undergoing wound repair.