The Effect of Ondansetron on Reducing Nausea Caused By Ketamine in Pediatric Patients Visiting Emergency Department; a Clinical Trial

Introduction: Nausea is a common side effect of ketamine in pediatric sedation and the controversy is still ongoing regarding use of anti-nausea drugs with ketamine to reduce this side effect. Thus, the present study was done aiming to evaluate the effectiveness of ondansetron in controlling the nausea caused by intramuscular (IM) and intravenous (IV) use of ketamine in pediatric sedation and analgesia. Methods: In the present single-blind randomized clinical trial, 1-18 year old children in need of sedation were divided into 4 treatment groups of IV ketamine, IM ketamine, IV ketamine and ondansetron, and IM ketamine and ondansetron, and prevalence of nausea and vomiting was compared between the groups as the main outcome of the study. Results: 120 children were studied (the most common age group 2-7 years 66.7%; 65.8% male). 18 (15.0%) patients were affected with nausea and vomiting. The prevalence of nausea in IV ketamine, IM ketamine, IV ketamine and ondansetron, and IM ketamine and ondansetron groups was 26.7%, 16.7%, 6.7% and 10.0%, respectively. There was no significant difference between the 4 studied groups regarding rate of nausea (p = 0.17). Conclusion: Based on the results of the present study, it seems that using ondansetron along with ketamine does not reduce nausea. Contradiction between studies is indicative of the need for further studies in this regard

اثر اندانسترون بر کاهش تهوع ناشی از کتامین در کودکان مراجعه کننده به بخش اورژانس؛ یک کارآزمایی بالینی

Introduction: Nausea is a common side effect of ketamine in pediatric sedation and the controversy is still ongoing regarding use of anti-nausea drugs with ketamine to reduce this side effect. Thus, the present study was done aiming to evaluate the effectiveness of ondansetron in controlling the nausea caused by intramuscular (IM) and intravenous (IV) use of ketamine in pediatric sedation and analgesia. Methods: In the present single-blind randomized clinical trial, 1-18 year old children in need of sedation were divided into 4 treatment groups of IV ketamine, IM ketamine, IV ketamine and ondansetron, and IM ketamine and ondansetron, and prevalence of nausea and vomiting was compared between the groups as the main outcome of the study. Results: 120 children were studied (the most common age group 2-7 years 66.7%; 65.8% male). 18 (15.0%) patients were affected with nausea and vomiting. The prevalence of nausea in IV ketamine, IM ketamine, IV ketamine and ondansetron, and IM ketamine and ondansetron groups was 26.7%, 16.7%, 6.7% and 10.0%, respectively. There was no significant difference between the 4 studied groups regarding rate of nausea (p = 0.17). Conclusion: Based on the results of the present study, it seems that using ondansetron along with ketamine does not reduce nausea. Contradiction between studies is indicative of the need for further studies in this regard. مقدمه: تهوع از عوارض شایع کتامین در آرام بخشی کودکان است و هنوز در خصوص استفاده از یک داروی ضد تهوع در کنار کتامین به منظور کاهش این عارضه، اختلاف نظر وجود دارد. بر این اساس مطالعه حاضر با هدف بررسی اثربخشی اندانسترون در کنترل تهوع ناشی از مصرف کتامین داخل عضلانی و داخل وریدی در آرامبخشی کودکان انجام پذیرفته است. روش کار: در کارآزمایی بالینی یک سوکور تصادفی حاضر کودکان 18-1 ساله نیازمند به آرامبخشی به چهار گروه تحت درمان با کتامین وریدی، کتامین عضلانی، کتامین وریدی و اندانسترون و کتامین عضلانی و اندانسترون تقسیم شدند و میزان بروز تهوع و استفراغ به عنوان پیامد اصلی مورد بررسی مطالعه، بین آنها به مقایسه گذاشته شد. يافته ها: 120 کودک مورد مطالعه قرار گرفتند (شایعترین گروه سنی 7-2 سال 7/66 درصد؛ 8/65 درصد پسر). 18 (0/15 درصد) بیمار دچار تهوع و استفراغ شدند. شیوع تهوع در گروه کتامین وریدی، کتامین عضلانی، ترکیب کتامین وریدی + اندانسترون و کتامین عضلانی+ اندانسترون به ترتیب برابر 7/26 درصد، 7/16 درصد، 7/6 درصد و 0/10 درصد بود. از نظر میزان تهوع تفاوت معنی داری بین چهار گروه مورد مطالعه مشاهده نشد (17/0 = p). نتيجه گيری: بر اساس نتایج  مطالعه حاضر به نظر می رسد که افزودن اندانسترون به کتامین منجر به تخفیف عارضه تهوع نمی شود. اختلاف نظر موجود بین مطالعات بیانگر نیاز به مطالعات بیشتر در این زمینه می باشد

Study of the Psychological Problems in 7-11 Year-old Children of Divorce Based on the Attitudes of Iranian Teachers and Mothers

The main objective of this study is to identify the psychological problems of 7-11 year-old children of divorce based on the lived experience of teachers and mothers. The research method used was one of a descriptive survey with the statistical population comprising elementary school male and female children aged 7-11. From this number, 280 comprised the sample selected from all the boys' and girls' schools in Esfahan using a multi-stage cluster sampling. The data collection instrument was the Achenbach questionnaire (Mother and Teacher inventory). The data were analyzed using Chi-square test where upon the results indicated that based on the mothers' reports, the commonest problems were complaints about physical pain (6.8%), withdrawal, depression, aggressive behavior (6.4%), and physical problems (6%). Furthermore, based on the teachers' reports, the commonest problems were anxiety or depression, physical and behavioral problems (6.4%), aggressive behavior, emotional problems (6%), and social problems (5.7%)