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Does intramuscular ondansetron have an effect on intramuscular ketamine-associated vomiting in children? A

Amir Nejati1, Seyyedhossein Seyyedhoseini Davarani1, Mohammad Taghi Talebian1

  • 1Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran.

The American Journal of Emergency Medicine
|December 16, 2019
PubMed

Insights

Intramuscular ondansetron significantly reduced vomiting in children receiving ketamine for procedural sedation. This finding supports ondansetron as an effective antiemetic for managing ketamine-associated nausea and vomiting.

Area of Science:

  • Pediatric Emergency Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Procedural sedation with ketamine is common in pediatric emergency departments.
  • Ketamine administration can lead to significant nausea and vomiting, impacting patient recovery.
  • Effective antiemetic strategies are needed to mitigate ketamine-associated gastrointestinal side effects.

Purpose of the Study:

  • To evaluate the efficacy of intramuscular ondansetron in preventing ketamine-associated vomiting in children.
  • To compare the incidence of vomiting between children receiving ketamine alone versus ketamine with intramuscular ondansetron.

Main Methods:

  • A randomized, double-blind, placebo-controlled, parallel-group clinical trial was conducted.
  • Participants included children aged 6 months to 16 years receiving ketamine for procedural sedation.
  • Patients received either ketamine alone or ketamine plus intramuscular ondansetron.

Main Results:

  • Vomiting occurred in 12.5% of patients receiving ondansetron versus 21.5% in the control group during recovery (P=0.03).
  • Vomiting before discharge was significantly lower in the ondansetron group (1.8%) compared to the control group (9.2%) (P<0.001).
  • Intramuscular ondansetron demonstrated a statistically significant reduction in ketamine-associated vomiting.

Conclusions:

  • Intramuscular ondansetron is an effective intervention for controlling ketamine-associated vomiting in pediatric procedural sedation.
  • The findings support the routine use of intramuscular ondansetron to improve outcomes for children receiving ketamine sedation.
Abstract

Keywords:
ChildrenKetamineOndansetron

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