소아의 케타민 근육주사 진정 요법 시 경구 온단세트론의 항구토 효과: 이중 눈가림 위약비교 무작위 대조군 연구
Effect of Oral Ondansetron on Vomiting Associated with Intramuscular Ketamine Sedation in Children: A Double-Blind, Radndomized, Placebo-Controlled Trial
최재연, 곽영호, 김도균, 정재윤, 서동범, 장익완,
소속 상세정보
최재연 ( Choi Jea-Yeon )
서울대학교병원 응급의학교실
곽영호 ( Kwak Young-Ho )
서울대학교병원 응급의학교실
김도균 ( Kim Do-Kyun )
서울대학교병원 응급의학교실
정재윤 ( Jung Jae-Yun )
서울대학교병원 응급의학교실
서동범 ( Suh Dong-Bum )
서울대학교병원 응급의학교실
장익완 ( Chang Ik-Wan )
서울대학교병원 응급의학교실
KMID : 1037620140010020083
Abstract
Purpose: The purpose of this study is to investigate the effect of oral ondansetron on the incidence of vomiting in children who receive intramuscular (IM) 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 IM ketamine (5 mg/kg) for ED procedures were randomized to receive either oral ondansetron (2 mg or 4 mg) or placebo 15 minutes before the ketamine injection. 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: Thirty two children were randomized to placebo and 31 to ondansetron. The groups were similar in age, sex, and fasting duration. ED vomiting was no significant difference with ondansetron: 7 of 31 (22.6%) versus 6 of 32 (18.8%), P=0.707, difference -3.8 (95% confidence interval -23.8% to 16.2%). Follow-up completed in 82.5%. The vomiting in the ED or after discharge in two groups, there was no significant difference: 7 of 27 (25.9%) versus 12 of 25 (48.0%), P=0.165, difference 22.1% (95% confidence interval -3.5% to 47.7%). ED length of stay and parental satisfaction were similar between groups.
Conclusion: There is no significant reduction of the incidence of vomiting in oral ondansetron group with IM ketamine procedural sedation in children.
키워드
Ondansetron; Ketamine; Conscious Sedation; Vomiting
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