The Difference in Time to Discharge Between Daytime and Nighttime Administration of Ketamine in Children

Area of Science:

• Pediatric Emergency Medicine
• Anesthesiology
• Sedation Pharmacology

Background:

• Timely discharge from the emergency department (ED) is crucial for pediatric care.
• Ketamine is a commonly used sedative for procedural sedation in children.
• Understanding factors influencing sedation duration can optimize patient flow.

Purpose of the Study:

• To compare the time to discharge for children receiving ketamine sedation for primary facial repair based on administration time (daytime vs. nighttime).

Main Methods:

• Retrospective, cross-sectional study of 562 children under 18 years old undergoing primary facial repair in 2019.
• Ketamine administered intramuscularly at 4 mg/kg, with additional doses if needed.
• Data collected on injection time, awakening time, and discharge using a postanesthesia discharge scoring system.

Main Results:

• No significant difference in discharge time was found between the daytime (8 a.m. - 8 p.m.) and nighttime (8 p.m. - 8 a.m.) ketamine administration groups.
• Statistical analysis showed no significant variation between the groups (P = 0.877 and P = 0.487).

Conclusions:

• The timing of ketamine administration (daytime vs. nighttime) does not impact the duration of sedation or time to discharge for children undergoing primary facial repair.
• These findings suggest that ketamine's efficacy for sedation in this pediatric population is consistent regardless of administration time.