Identifying non-invasive methods for anxiolysis is becoming increasingly important in the pediatric emergency department (ED). Few studies have examined the use of intranasal (IN) ketamine for procedural anxiolysis. We aim to evaluate if IN ketamine provides satisfactory anxiolysis for patients undergoing laceration repair based on anxiety and sedation scoring. We also evaluated the feasibility of using IN ketamine in future trials based on its tolerability and side-effects. A pilot study evaluating IN ketamine in the treatment of procedural anxiety for patients, 2 years and older, weighing 40 kg or less, presenting to the pediatric ED with lacerations. The need for anxiolysis was defined by an elevated modified-Yale Preoperative Anxiety Scale—Short Form (mYPAS-SF) score. Patients received 5 mg/kg of IN ketamine in addition to topical anesthesia, mYPAS-SF scoring before and during the procedure, sedation scoring, adverse events, vital signs, age, weight, laceration size and location, and satisfaction surveys were recorded. Twenty-five patients were enrolled, with mean age of 61 ± 29.2 months and mean weight of 21 ± 6.4 kg. Lacerations were located on the face, extremities, and groin with mean size of 2.1 cm. A decrease in anxiety levels was observed, from median m-YPAS-SF score of 66.7 (62.50–80.2) to 33.3 (27.09–52.00), p < 0.001. Among the patients, 92% (n = 23) were less anxious during the procedure. IN ketamine appears to be safe and well-tolerated with a positive impact on procedural anxiety. A dosage of 5 mg/kg is a reasonable starting point, as 80% of patients had appropriate anxiolysis.

确定用于抗焦虑的非侵入性方法在儿科急诊科 (ED) 中变得越来越重要。很少有研究检查鼻内 (IN) 氯胺酮在程序性抗焦虑中的应用。我们的目的是根据焦虑和镇静评分评估 IN 氯胺酮是否为接受撕裂修复的患者提供令人满意的抗焦虑作用。我们还根据其耐受性和副作用评估了在未来试验中使用 IN 氯胺酮的可行性。一项评估 IN 氯胺酮治疗 2 岁及以上、体重 40 公斤或以下、因撕裂伤到儿科急诊部的程序性焦虑症的初步研究。是否需要抗焦虑是由升高的改良耶鲁术前焦虑量表 - 简式 (mYPAS-SF) 评分定义的。除了局部麻醉外，患者还接受了 5 mg/kg 的 IN 氯胺酮，记录术前和术中的 mYPAS-SF 评分、镇静评分、不良事件、生命体征、年龄、体重、裂伤大小和位置以及满意度调查。招募了 25 名患者，平均年龄为 61 ± 29.2 个月，平均体重为 21 ± 6.4 kg。撕裂伤位于面部、四肢和腹股沟，平均大小为 2.1 厘米。观察到焦虑水平下降，从中位数 m-YPAS-SF 得分 66.7 (62.50–80.2) 到 33.3 (27.09–52.00)，p  < 0.001。在这些患者中，92% (n = 23) 在手术过程中不那么焦虑。IN 氯胺酮似乎安全且耐受性良好，对程序性焦虑有积极影响。5 mg/kg 的剂量是一个合理的起点，因为 80% 的患者具有适当的抗焦虑作用。