• Amir Nejati, Seyyedhossein Seyyedhoseini Davarani, Mohammad Taghi Talebian, Firouzi Hossein, and Hamideh Akbari.
• Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: anejati@tumsac.ir.
• Am J Emerg Med. 2020 Jul 1; 38 (7): 1301-1304.

ObjectiveThis study was conducted to determine the effect of intramuscular ondansetron on ketamine-associated vomiting in children undergoing procedural sedation.MethodsThis 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.ResultsOf 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 <0.001, respectively).ConclusionIntramuscular ondansetron is effective in controlling ketamine-associated vomiting.Copyright © 2019 Elsevier Inc. All rights reserved.

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