The Effect of Ondansetron on Reducing Nausea Caused By Ketamine in Pediatric Patients Visiting Emergency Department; a Clinical Trial
Iranian Journal of Emergency Medicine,
Vol. 4 No. 1 (2017),
AbstractIntroduction: Nausea is a common side effect of ketamine in pediatric sedation and the controversy is still ongoing regarding use of anti-nausea drugs with ketamine to reduce this side effect. Thus, the present study was done aiming to evaluate the effectiveness of ondansetron in controlling the nausea caused by intramuscular (IM) and intravenous (IV) use of ketamine in pediatric sedation and analgesia. Methods: In the present single-blind randomized clinical trial, 1-18 year old children in need of sedation were divided into 4 treatment groups of IV ketamine, IM ketamine, IV ketamine and ondansetron, and IM ketamine and ondansetron, and prevalence of nausea and vomiting was compared between the groups as the main outcome of the study. Results: 120 children were studied (the most common age group 2-7 years 66.7%; 65.8% male). 18 (15.0%) patients were affected with nausea and vomiting. The prevalence of nausea in IV ketamine, IM ketamine, IV ketamine and ondansetron, and IM ketamine and ondansetron groups was 26.7%, 16.7%, 6.7% and 10.0%, respectively. There was no significant difference between the 4 studied groups regarding rate of nausea (p = 0.17). Conclusion: Based on the results of the present study, it seems that using ondansetron along with ketamine does not reduce nausea. Contradiction between studies is indicative of the need for further studies in this regard.
How to Cite
Alimohammadi H, Shojaee M, Samiei M, Abyari S, Vafaee A, Mirkheshti A. Nerve stimulator guided axillary block in painless reduction of distal radius fractures; a randomized clinical trial. Emergency. 2013;1(1):11.
Azizkhani R, Esmailian M. Rectal Thiopental versus Intramuscular Ketamine in Pediatric Procedural Sedation and Analgesia; a Randomized Clinical Trial. Emergency. 2015;3(1):22.
Barzegari H, Zohrevandi B, Masoumi K, Forouzan A, Darian AA, Khosravi S. Comparison of oral midazolam and promethazine with oral midazolam alone for sedating children during computed tomography. Emergency. 2015;3(3):109.
Azizkhani R, Kanani S, Sharifi A, Golshani K, Masoumi B, Ahmadi O. Oral Chloral Hydrate Compare with Rectal Thiopental in Pediatric Procedural Sedation and Analgesia; a Randomized Clinical Trial. Emergency. 2014;2(2):85.
Nowak RM, Nanayakkara P, DiSomma S, Levy P, Schrijver E, Huyghe R, et al. Noninvasive hemodynamic monitoring in emergency patients with suspected heart failure, sepsis and stroke: the PREMIUM registry. The western journal of emergency medicine. 2014;15(7):786-94.
Prasad V, Cheung M, Cifu A. Chest pain in the emergency department: the case against our current practice of routine noninvasive testing. Archives of internal medicine. 2012;172(19):1506-9.
Schneeweiss S. Pain and sedation of children in the emergency setting. Encyclopedia of Pain: Springer; 2013. p. 2572-7.
Majidinejad S, Taherian K, Esmailian M, Khazaei M, Samaie V. Oral midazolam-ketamine versus midazolam alone for procedural sedation of children undergoing computed tomography; a randomized clinical trial. Emergency. 2015;3(2):64.
Lee JS, Jeon WC, Park EJ, Min YG, Kim GW, Jung YS, et al. Does ondansetron have an effect on intramuscular ketamine-associated vomiting in children? A prospective, randomised, open, controlled study. Journal of paediatrics and child health. 2014;50(7):557-61.
Thorp AW, Brown L, Green SM. Ketamine-associated vomiting: is it dose-related? Pediatric emergency care. 2009;25(1):15-8.
Wing R, Steele D, Duffy S, Chapman L. Triage Administration of Ondansetron for Pediatric Vomiting Is Associated with Improved Outcomes. Pediatrics. 2016;137(Supplement 3):297A-A.
Langston WT, Wathen JE, Roback MG, Bajaj L. Effect of ondansetron on the incidence of vomiting associated with ketamine sedation in children: a double-blind, randomized, placebo-controlled trial. Annals of emergency medicine. 2008;52(1):30-4.
Green SM, Roback MG, Krauss B, Brown L, McGlone RG, Agrawal D, et al. Predictors of emesis and recovery agitation with emergency department ketamine sedation: an individual-patient data meta-analysis of 8,282 children. Annals of emergency medicine. 2009;54(2):171-80. e4.
Roback MG, Bajaj L, Wathen JE, Bothner J. Preprocedural fasting and adverse events in procedural sedation and analgesia in a pediatric emergency department: are they related? Annals of emergency medicine. 2004;44(5):454-9.
Green SM, Roback MG, Krauss B. Anticholinergics and ketamine sedation in children: a secondary analysis of atropine versus glycopyrrolate. Academic Emergency Medicine. 2010;17(2):157-62.
Green SM, Roback MG, Kennedy RM, Krauss B. Clinical practice guideline for emergency department ketamine dissociative sedation: 2011 update. Annals of emergency medicine. 2011;57(5):449-61.
Roback MG, Wathen JE, MacKenzie T, Bajaj L. A randomized, controlled trial of iv versus im ketamine for sedation of pediatric patients receiving emergency department orthopedic procedures. Annals of emergency medicine. 2006;48(5):605-12.
Heinz P, Geelhoed G, Wee C, Pascoe E. Is atropine needed with ketamine sedation? A prospective, randomised, double blind study. Emergency medicine journal. 2006;23(3):206-9.
- Abstract Viewed: 54291 times
- PDF (فارسی) Downloaded: 221 times
- HTML (فارسی) Downloaded: 100 times