Dexmedetomidine vs Ketamine for Pediatric Procedural Sedation in the Emergency Department: A Randomized Clinical Trial

OBJECTIVE: To design and conduct the effectiveness of Ketamine vs Dexmedetomidine in children’s sedation at emergency department (ED). METHODS: This randomized clinical trial study was carried out at the two trauma centers in Mashhad, Iran. The patients were divided into two groups by means of a random numbers table to be treated with Ketamine (N=20) or Dexmedetomidine (N=20). Their demographic information and sedation times of drugs were collected and analyzed. RESULTS: In general, sedation time was significantly higher in the ketamine group, 14.35 minutes (IQR:9.82-19) than in the dexmedetomidine group, 9.7 minutes (8.35-14.23) (p=0.023). Time of injection to complete anesthesia was 45.25 (IQR:30-58) and 72 (IQR:60.25-82) minutes in ketamine and dexmedetomidine groups, respectively (p<0.01). In the case of recovery, grade 4 of the Ramsey scale was statistically more prevalent in dexmedetomidine (45%) than in the ketamine group (p=0.0001). CONCLUSION: This study demonstrated that dexmedetomidine could be used in cases where a shorter sedation time is vital. Ketamine could be a better choice where full recovery time (from injection) matters most. Clinical Trial registration code: IR.MUMS.fm.REC.1396.534.