Comparison of N2O Inhalation and Ketamine in Pediatric PSA

Comparison of N2O Inhalation and Ketamine IV Injection for Sedation in the Treatment of Laceration of Pediatric Patients.

• Ketamine provides effective and relatively safe sedation analgesia for primary closure of lacerated pediatric patients
• However, deep sedation and adverse effects suggest the opportunity to develop alternative strategies
• We compared the efficacy and adverse effects of ketamine to those of N2O gas for analgesia and anxiolysis during primary repair of lacerated pediatric patients

• There were 32 children who were randomly assigned
• Recovery times were markedly shorter in the N2O group compared with those in the ketamine group (median, 0.0 min (interquartile range [IQR], 0.0-4.0 min) vs. median, 21.5 min (IQR, 12.5-37.5 min), N2O vs. ketamine, respectively, p < 0.05)
• Sedation levels were deeper in the ketamine group than in the N2O group, but pain scales were comparable between groups
• No difference was observed in the satisfaction scores by physicians, parents, or nurses.
• N2O inhalation was preferable to injectable ketamine for pediatric patients because it is safe, allows for a faster recovery, maintains sufficient sedation time, and does not induce unnecessarily deep sedation

Inclusion Criteria:

• Pediatric patients with lacerated wound

Exclusion Criteria:

• Contraindication of ketamine or N2O gas
• A wound around eye and mouth