Evidence map›Paper›PMID 28319161›Full record

SynthesisPloS one2017

Intranasal ketamine for procedural sedation and analgesia in children: A systematic review.

Naveen Poonai, Kyle Canton, Samina Ali, Shawn Hendrikx, Amit Shah, Michael Miller, Gary Joubert, Michael Rieder, Lisa Hartling

2 registry-linked trialsOpen access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 32 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 3 pooled it
5.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04820205 nacompletednot on this mapstarted 2021, after this paper: background citation

Comparison of Oral Chloral Hydrate and Combination of Intranasal Dexmedetomidine and Ketamine for Procedural Sedation in Children: a Randomized Controlled Trial

TypeinterventionalSponsorSeoul National University HospitalRan2021 to 2024Enrolled136ConditionsSedationArmsIntranasal dexmedetomidine and ketamine, Oral chloral hydrate
NCT04822064 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Comparison of Oral Chloral Hydrate and Combination of Intranasal Dexmedetomidine and Ketamine for Rescue After Failed Pediatric Procedural Sedation: a Randomized Controlled Trial

TypeinterventionalSponsorSeoul National University HospitalRan2022 to 2025Enrolled70ConditionsSedationArmsIntranasal dexmedetomidine and ketamine, Oral chloral hydrate
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 92 citations in OpenAlex.

  1. Pooled it
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  16. Ketamine-assisted buprenorphine initiation: a pilot case series.Addiction science & clinical practice · 2024
    Article
  17. Review
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  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Naveen PoonaiDepartment of Pediatrics, Schulich School of Medicine and Dentistry, London, Ontario, Canada.ORCID http://orcid.org/0000-0003-1540-0413
Kyle CantonDivision of Emergency Medicine, London Health Sciences Centre, London, Ontario, Canada.
Samina AliDepartment of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Shawn HendrikxDepartment of Pediatrics, Schulich School of Medicine and Dentistry, London, Ontario, Canada.
Amit ShahDivision of Emergency Medicine, London Health Sciences Centre, London, Ontario, Canada.
Michael MillerDepartment of Pediatrics, Schulich School of Medicine and Dentistry, London, Ontario, Canada.
Gary JoubertDepartment of Pediatrics, Schulich School of Medicine and Dentistry, London, Ontario, Canada.
Michael RiederDepartment of Pediatrics, Schulich School of Medicine and Dentistry, London, Ontario, Canada.
Lisa HartlingAlberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta.
Western University · CALondon Health Sciences Centre · CAUniversity of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKetamine is commonly used for procedural sedation and analgesia (PSA) in children. Evidence suggests it can be administered intranasally (IN). We sought to review the evidence for IN ketamine for PSA in children.

methodsWe performed a systematic review of randomized trials of IN ketamine in PSA that reported any sedation-related outcome in children 0 to 19 years. Trials were identified through electronic searches of MEDLINE (1946-2016), EMBASE (1947-2016), Google Scholar (2016), CINAHL (1981-2016), The Cochrane Library (2016), Web of Science (2016), Scopus (2016), clinical trial registries, and conference proceedings (2000-2016) without language restrictions. The methodological qualities of studies and the overall quality of evidence were evaluated using the Cochrane Collaboration's Risk of Bias tool, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, respectively.

resultsThe review included 7 studies (n = 264) of children ranging from 0 to 14 years. Heterogeneity in study design precluded meta-analysis. Most studies were associated with a low or unclear risk of bias and outcome-specific ratings for quality of evidence were low or very low. In four of seven studies, IN ketamine provided superior sedation to comparators and resulted in adequate sedation for 148/175 (85%) of participants. Vomiting was the most common adverse effect; reported by 9/91 (10%) of participants.

conclusionsIN ketamine administration is well tolerated and without serious adverse effects. Although most participants were deemed adequately sedated with IN ketamine, effectiveness of sedation with respect to superiority over comparators was inconsistent, precluding a recommendation for PSA in children.

Indexed as

Administration, IntranasalAdolescentAnalgesicsChildChild, PreschoolHumansHypnotics and SedativesInfantInfant, NewbornKetamineRandomized Controlled Trials as TopicAnalgesicsHypnotics and SedativesKetamine

Identifiers

PMID28319161
PMCPMC5358746
OpenAlexW2601885813

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.