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To compare the efficacy of oral midazolam alone and in combination with oral ketamine for pediatric laceration repairs, researchers in Israel randomized 60 healthy children (age range, 1–10 years) who required sedation for laceration repairs to receive either regimen. All patients received topical lidocaine, epinephrine, and tetracaine at triage, and premedication with oral midazolam (0.5 mg/kg) followed by oral ketamine (5 mg/kg) or placebo, as well as 1% intradermal lidocaine, prior to suturing.
Most patients (80%) had facial lacerations. Fewer patients in the midazolam-ketamine group than in the midazolam-placebo group required intravenous sedation (2 vs. 8 patients), and these patients were excluded from the analysis. Pain (rated by pare…