Anxiety and Vomiting in Kids Undergoing Sedation in the ED

TOPLINE:

Preprocedural anxiety levels among children undergoing procedural sedation and analgesia (PSA) with ketamine in the emergency department are not associated with the incidence of vomiting, according to a new study.

METHODOLOGY:

• The study was conducted between 2019 and 2020 at a hospital in Tehran and enrolled 93 children (mean age, 3.95 years; 53.8% boys) who were candidates for PSA with intramuscular ketamine in the emergency department.
• Anxiety was measured using the modified Yale Preoperative Anxiety Scale (mYPAS) in both the waiting and operating rooms.
• The main outcome measured was the incidence of vomiting, defined as any retching or vomiting recorded after ketamine administration during the hospital stay or a 24-hour follow-up via phone call after discharge.

TAKEAWAY:

• Overall, 23 children experienced at least one episode of vomiting, with 19 vomiting only in the hospital, four after discharge, and two during both periods. The mean anxiety scores were 47.9 in the waiting room and 57.6 in the operating room.
• Children who vomited had a higher average anxiety score than those who did not (58.3 vs 51.0); however, this difference was not statistically significant.
• High anxiety levels (mYPAS score ≥ 40) were observed in 57% children in the waiting room and 72% in the operating room.

IN PRACTICE:

“While it is prudent to reduce anxiety in children, this study did not show that severity of this condition before PSA in children was associated with risk of vomiting during the hospital stay or after discharge,” the authors wrote.

SOURCE:

The study was led by Elham Mahmoodi, Hormozgan University of Medical Sciences, Bandar Abbas, Iran, and published online on October 09, 2024, in BMC Emergency Medicine.

LIMITATIONS:

Missing data owing to self-reporting, particularly regarding the occurrence of post-discharge retching and vomiting, could have resulted in underreporting and biased effect estimates. In addition, the single-center design of the study may have limited its generalizability.

DISCLOSURES:

The study did not receive any external funding. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.