Not enough evidence to determine if penthrox is more effective than ketamine in pediatric emergency medicine
Date First Published:
May 28, 2021
Last Updated:
May 28, 2021
Report by:
Dr Devon Stride, Resident Physician (McMaster University )
Search checked by:
Dr Maggie Vincent, McMaster University
Three-Part Question:
Is [penthrox more effective than ketamine] for [adequate procedural sedation] in [pediatric patients] in the emergency department?
Clinical Scenario:
A 2 year old boy presents to the emergency department with a large laceration to his temple after he fell onto a corner of a coffee table. He will require procedural sedation to suture the laceration. You ask the bedside nurse to start an IV to administer ketamine. As the child squirms and cries getting the IV, you wonder, is there a better option?
Search Strategy:
Embase 1966 to 01/2021 using the OVID interface
Medline 1996 to 01/2021 using the OVID interface
Medline 1996 to 01/2021 using the OVID interface
Search Details:
([penthrox.mp. OR exp methoxyflurane/] AND [ketamine.mp. OR exp ketamine/])
Outcome:
464 papers, of which nine were duplicates and 455 were irrelevant.
Author Commentary:
There are several studies that demonstrate the effectiveness of penthrox for procedural sedation in children, but none that use a comparator group.
Bottom Line:
More comparative research is required to assess the effectiveness of penthrox for procedural sedation in children compared to ketamine in the emergency department.