Randomised trials comparing ketamine with other sedatives
| Reference | Randomisation | Number of patients | Treatment arms | Outcomes | Results | Comments |
|---|---|---|---|---|---|---|
| *See text. | ||||||
| McGlone et al19 | No (alternated treatment arms) | 102 | IN midazolam 0.5 mg/kg, IM ketamine 2.5 mg/kg | Behaviour, restraint, parent satisfaction | Less restraint with ketamine, parent preference for ketamine | No blinding, no randomisation, assessment of sedation by operator |
| Younge and Kendall43 | Not clear | 59 | Oral ketamine 10 mg/kg, oral midazolam 0.7 mg/kg | Tolerance, time to sedation, parental acceptance, adverse events | Lower sedation score with ketamine and better tolerance | Different local anaesthesia, not powered, ?blinded, low numbers, tolerance scale not validated |
| McGlone et al20 | No (alternated treatment arms) | 87 | IM midazolam 0.4 mg/kg +/− flumazenil, IM ketamine 2.5 mg/kg | Behaviour, restraint, parent satisfaction | Less agitation and better parent satisfaction with ketamine, less restraint needed with ketamine | Initially combative children selected for ketamine, no blinding |
| Acworth* et al44 | Computer, sealed envelopes | 53 | IN midazolam 0.4 mg/kg, IV ketamine 1 mg/kg plus IV midazolam 0.1 mg/kg | Physiology, sedation score, parent assessment of sedation | Better sedation with ketamine but ldquo;deeper,” better parent and doctor satisfaction | Good blinding. ?bias |