Abstract
Study objectives: Conscious sedation has been used as a useful technique for reducing pain and anxiety in children undergoing painful procedures. Which agent or combination of agents for use in children is the safest in the emergency department (ED) setting remains controversial. Methods: This was a prospective evaluation of 2 conscious sedation drug regimens, ketamine versus opioid/midazolam. Results: There were 118 total conscious sedation procedures. The most common indications for conscious sedation were fracture reduction 91 (65.9%), laceration repair 25 (18.1%), dislocation reduction 6 (4.3%), and dental procedures 5 (3.6%). Ketamine was used in 67 (56.7%) procedures, average dose 1.2±0.4 mg/kg (95% confidence interval [CI] 1.1 to 1.3 mg/kg, range 0.8 to 3.1 mg/kg). Mean age was 6.6±3.9 years (95% CI 5.6 to 7.6 years), which was significantly lower than that for opioids/midazolam ( P P Conclusion: Conscious sedation in children in the ED using these techniques is safe; however, ketamine was used more often in younger children than opioid/midazolam and resulted in a deeper sedation score but no difference in total recovery time.
Published Version
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