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CC BY-NC-ND 4.0 · Arch Plast Surg 2023; 50(01): 030-036
DOI: 10.1055/s-0042-1759792
Pediatric/Craniomaxillofacial/Head & Neck
Original Article

A Survey on Procedural Sedation and Analgesia for Pediatric Facial Laceration Repair in Korea

Dongkyu Lee 
1   Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital, Daegu, Korea
,
Hyeonjung Yeo 
1   Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital, Daegu, Korea
,
Yunjae Lee 
2   Cheongdam Okay Plastic Surgery Clinic, Seoul, Korea
,
Hyochun Park 
1   Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital, Daegu, Korea
,
Hannara Park 
1   Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital, Daegu, Korea
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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

Authors' Contributions

H.Y., Ha.P., and D.L. contributed toward conceptualization. D.L. and Y.L. did the data curation. H.Y., D.L., Y.L., Hy.P., and Ha. P. did the formal analysis and methodology. H.Y., Ha.P., D.L., and Y.L. did the project administration and wrote the original draft. H.Y. did the supervision. H.Y., F.L., Hy.P., and Ha.P. did the writing -review and editing. All the authors approved the final manuscript.


Ethical Approval

The study protocol followed the ethical guidelines of the Declaration of Helsinki. The need to seek ethics approval was waived by the Daegu Fatima Hospital Institutional Review Board (IRB exemption no. DFE19ORIO047).




Publication History

Received: 15 June 2022

Accepted: 19 October 2022

Article published online:
06 February 2023

© 2023. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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