Disel NR, Yilmaz HL, Sertdemir Y, et al. Etomidate versus ketamine: Effective use in emergency procedural sedation for pediatric orthopedic injuries. Ped Emerg Care; 2015 (ePub ahead of print).
Main Points:
- This study was a single-blinded randomized, controlled trial of etomidate + fentanyl versus ketamine sedation in 44 children aged 7-18 years old with orthopedic injuries.
- The mean amount of drugs used to achieve sedation were etomidate 0.25 mg/kg + fentanyl 1.3 micrograms/kg v. ketamine 1.25 mg/kg
- Mean induction time was 4.3 minutes for etomidate versus 2.2 minutes for ketamine.
- There was no difference between groups for recovery times, adverse events, or post-sedation observation times.
- 14 patients (32%) reported adverse events, but there were no serious adverse events. Adverse events seen were nausea, urticarial, hypoxemia, myoclonus, excessive secretions and pain at injection site.
- Etomidate+fentanyl led to less recall of pain than ketamine
- One child in the etomidate+fentanyl group was admitted after failed reduction.
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