Does intramuscular ondansetron have an effect on intramuscular ketamine-associated vomiting in children? A prospective, randomized, double blind, controlled study

• Published in: The American journal of emergency medicine 2020-07, Vol.38 (7), p.1301-1304
• Main Authors: Nejati, Amir, Davarani, Seyyedhossein Seyyedhoseini, Talebian, Mohammad Taghi, Hossein, Firouzi, Akbari, Hamideh
• Format: Article
• Language: English
• Subjects: Anesthesia; Blood pressure; Children; Clinical trials; Data collection; Double-blind studies; Emergency medical care; Hypertension; Ketamine; Ondansetron; Patients; Pediatrics; Statistical analysis; Vomiting
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2019.158445

This study was conducted to determine the effect of intramuscular ondansetron on ketamine-associated vomiting in children undergoing procedural sedation. This randomized, double-blind, placebo-controlled, parallel-group clinical trial was conducted at the emergency departments of two university-affiliated tertiary care hospitals. Eligible participants included all 6-month to 16-year-old children who received IM ketamine for PSA in the ED. A convenience sampling approach was used and a block randomization method was applied (blocks of four) using a computer-generated random sequence. Patients received ketamine 4 mg/kg or ketamine 4 mg/kg plus ondansetron 0.1 mg/kg intramuscularly. All findings including the occurrence of vomiting and its frequency were then recorded in the data collection sheets. Of 56 patients who received ondansetron plus ketamin, 7 (12.5%) and 1 (1.8%) experienced vomiting during recovery and before discharge and Of 65 patients in the control group, 14 (21.5%) and 6 (9.2%) experienced vomiting during recovery and before discharge, respectively. The observed differences in the rates of vomiting during recovery and at discharge were statistically significant between the two groups (P-value of 0.03 and