Abstract
Background Most children with facial lacerations require sedation for primary sutures. However,
sedation guidelines for invasive treatment are lacking. This study evaluated the current
status of the sedation methods used for pediatric facial laceration repair in Korea.
Methods We surveyed one resident in each included plastic surgery training hospital using
face-to-face interviews or e-mail correspondence. The health care center types (secondary
or tertiary hospitals), sedation drug types, usage, and dosage, procedure sequence,
monitoring methods, drug effects, adverse events, and operator and guardian satisfaction
were investigated.
Results We included 45/67 hospitals (67%) that used a single drug, ketamine in 31 hospitals
and chloral hydrate in 14 hospitals. All health care center used similar sedatives.
The most used drug administered was 5 mg/kg intramuscular ketamine (10 hospitals;
32%). The most common chloral hydrate administration approach was oral 50 mg/kg (seven
hospitals; 50%). Twenty-two hospitals (71%) using ketamine followed this sequence:
administration of sedatives, local anesthesia, primary repair, and imaging work-up.
The most common sequence used for chloral hydrate (eight hospitals; 57%) was local
anesthesia, administration of sedatives, imaging work-up, and primary repair. All
hospitals that used ketamine and seven (50%) of those using chloral hydrate monitored
oxygen saturation. Median operator satisfaction differed significantly between ketamine
and chloral hydrate (4.0 [interquartile range, 4.0–4.0] vs. 3.0 [interquartile range,
3.0–4.0]; p <0.001).
Conclusion The hospitals used various procedural sedation methods for children with facial lacerations.
Guidelines that consider the patient's condition and drug characteristics are needed
for safe and effective sedation.
Keywords
ketamine - chloral hydrate - hypnotics and sedatives - pediatrics - surveys and questionnaires
