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Ketamine and atropine for pediatric sedation: a prospective double-blind randomized controlled trial

Payman Asadi1, Hamed-Basir Ghafouri, Mohammadreza Yasinzadeh

  • 1Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Pediatric Emergency Care
|February 1, 2013
PubMed

Insights

Adding atropine to ketamine sedation in children significantly reduces hypersalivation. This combination proved safe, with no adverse effects on procedure duration or success rates in emergency departments.

Area of Science:

  • Pediatric Emergency Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Sedation in pediatric emergency care presents challenges for physicians.
  • Effective medications with minimal complications and good analgesia are crucial.
  • This study evaluated ketamine's adverse effects with atropine versus placebo.

Purpose of the Study:

  • To assess the safety and efficacy of adding atropine to ketamine for pediatric procedural sedation.
  • To compare adverse effects, specifically hypersalivation, between ketamine with atropine and ketamine with placebo.
  • To determine the impact on procedure and sedation duration.

Main Methods:

  • Prospective randomized controlled trial with 200 pediatric patients (2-15 years).
  • Two groups received ketamine (1 mg/kg IV); one group also received atropine (0.01 mg/kg IV), the other received placebo.
  • Adverse effects and treatment durations were recorded.

Main Results:

  • No significant differences in mean age, procedure time, or sedation duration between groups.
  • Hypersalivation was significantly reduced in the atropine group (12% vs. 28%).
  • Nausea and vomiting showed differences, but only hypersalivation reached statistical significance. Low oxygen saturation (2%) and no apnea/laryngospasm reported.

Conclusions:

  • Atropine addition to ketamine significantly mitigates hypersalivation in pediatric procedural sedation.
  • This combination does not negatively impact procedure duration or success rates.
  • Ketamine with atropine is a safe and effective option for managing hypersalivation during pediatric sedation.
Abstract

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