PMID: 11310460Apr 20, 2001Paper

A comparison of intramuscular ketamine with high dose intramuscular midazolam with and without intranasal flumazenil in children before suturing

Emergency Medicine Journal : EMJ
R McGloneS Hollis

Abstract

(a) To compare the use of high dose intramuscular midazolam with and without intranasal flumazenil in children after suturing. (b) To compare the use of high dose intramuscular midazolam with low dose intramuscular ketamine in children before suturing. 87 children, aged between 1 and 7 years, presenting with simple wounds needing sedation, were studied. Children considered combative (n=47) were given ketamine (2.5 mg/kg intramuscularly). The remaining 40 children were given midazolam (0.4 mg/kg intramuscularly) with and without flumazenil (25 microg/kg, intranasally). The median oxygen saturation was 97% in both midazolam groups. Flumazenil significantly reduced the amount of agitation during recovery (p=0.048) and also the time at which children were ready for discharge (median 55 versus 95 minutes, p value <0.001). After discharge both midazolam groups had an unsteady gait (75%) and there was no significant difference in the duration. As expected because of the deliberate selection of combative children into the ketamine group, the pre-sedation behaviour was slightly more disturbed compared with the midazolam group (p=0.10). However, the ketamine group was less agitated during local anaesthetic and suturing p<0.001. Intramusc...Continue Reading

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Citations

Apr 27, 2004·Emergency Medicine Journal : EMJ·M C Howes
Apr 3, 2012·Annales Françaises D'anesthèsie Et De Rèanimation·G Chéron, UNKNOWN groupe d’experts Sfar-SFMU
Mar 27, 2012·Annales Françaises D'anesthèsie Et De Rèanimation·G Orliaguet, UNKNOWN groupe d’experts Sfar-SFMU
Mar 31, 2012·Annales Françaises D'anesthèsie Et De Rèanimation·G Orliaguet, UNKNOWN groupe d’experts Sfar-SFMU
Jun 9, 2009·Annals of Emergency Medicine·Steven M GreenUNKNOWN Emergency Department Ketamine Meta-Analysis Study Group
Feb 10, 2009·Annals of Emergency Medicine·Steven M GreenUNKNOWN Emergency Department Ketamine Meta-Analysis Study Group
Dec 19, 2008·The American Journal of Emergency Medicine·Reuben J Strayer, Lewis S Nelson
Nov 26, 2008·Annals of Emergency Medicine·Maala BhattUNKNOWN Consensus Panel on Sedation Research of Pediatric Emergency Research Canada (PERC) and the Pediatric Emergency Care Applied
Nov 3, 2007·The Journal of Emergency Medicine·Christopher S WeaverWilliam H Cordell
Apr 10, 2007·International Journal of Pediatric Otorhinolaryngology·Gülcan ErkVildan Taşpinar
Apr 5, 2003·Emergency Medicine·Andries Cromhout
Oct 16, 2012·Paediatric Anaesthesia·Arun K ThevarajaMayank Aggarwal
Dec 17, 2014·The Journal of Emergency Medicine·Benjamin F JacksonJoseph D Losek
Dec 6, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Charles Schleien, Ariel Brandwein
Jan 1, 2009·Pediatric Emergency Care·Andrea W ThorpSteven M Green

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